We previously reported satisfactory therapeutic results of
cisplatin-based cyclic balloon-occluded arterial infusion
chemotherapy (BOAI) as
neoadjuvant chemotherapy, which enabled treatment by
hysterectomy in patients with advanced
cervical cancer. We also reported expression of apoptosis among these patients and determined that the bax gene is related to this apoptosis. In the present study, we investigated the relationship between the effectiveness of BOAI
therapy and expression of apoptosis regulatory genes and
proteins in these cases. The subjects were 27 women with advanced
cervical cancer classified as FIGO (International Federation of Gynecology and Obstetrics) stage III or higher who were admitted to the Department of Gynecology, Osaka City University Medical School Hospital between 2000 and 2003. All patients were treated by BOAI, and expression of
cancer cell apoptosis was examined by the TUNEL method, expression of bax, bcl-2 and bcl-xL
proteins were examined by immunohistochemistry, and expression of bax, bcl-2 and bcl-xL
mRNA was examined by quantitative RT-PCR before and 3 days after BOAI. The effectiveness of BOAI
therapy was thus determined. The 20 patients in whom BOAI was effective showed significantly higher expression of the
bax protein and gene after BOAI, and
cancer cell apoptosis was accelerated. On the other hand, the 7 patients in whom BOAI was ineffective showed significantly higher expression of the
bcl-xL protein and gene after BOAI. These results suggest that bax/bcl-xL expression can be used as an
indicator of the effectiveness of BOAI
therapy.