Caspase 3 and Survivin Expressions as a Predictor of Response to Radiation Therapy in Advanced Stage Cervical Cancer

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Abstract

Objective: To identify prognostic factors of advanced stage cervical cancer which was treated by radiation therapy, so that they can be implemented to support treatment in order to increase the success of therapeutic response in advanced stage cancer.Methods: Observational analytic historical cohort method study was conducted in Dr. Cipto Mangunkusumo General Hospital and 38 cases of stage IIB and IIIB cervical cancers receiving a complete radiation therapy were involved. Data were retrieved from medical records and cervical biopsies examination results. Paraffin blocks of cervical biopsies were examined histopathologically using HE staining followed by IHC. The expression of caspase 3 and survivin were then assessed by IRS scoring. Case group included 5 samples with negative therapeutic response, which means the therapeutic response other than complete response. Control group included 33 samples with positive therapeutic response which have complete response to therapy. The collected data were analyzed by univariate, bivariate, and multivariate analysis.Results: Demographic and clinicohistopathologic data were not significantly related to the occurrence of negative response to radiation therapy. Negative cytoplasmic caspase 3 expression has a predictive value of 90.75% for the occurrence of a negative response to radiation therapy (RR=9.81, CI 95%=1.231-78.286, p=0.019). Positive cytoplasmic survivin has a predictive value of 86.75% for the occurrence of a negative response to radiation therapy (RR=6.55, CI 95%=2.659-16.119, p=0.000). Nuclear caspase 3 and survivin expressions have no significant relation to the occurrence of a negative response to radiation therapy. Clinical response to radiation is influenced by clinic ohisto pathologic factors, caspase 3, and survivin expression altogether.Conclusion: Negative cytoplasmic caspase 3 expression and positive cytoplasmic survivin have predictive value for the risk of a negative response to radiation therapy to occur
Original languageEnglish
JournalIndonesian Journal of Obstetrics and Gynecology
Publication statusPublished - Jul 2011

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