Cervical cancer is the most common
cancer in Indian women. Oxidative stress is potentially harmful to cells and ROS are involved in multistage
carcinogenesis, in initiation and promotion. The aim was to study the alterations in the circulating pro-/
anti-oxidants in advanced
cervical cancer patients, before and after
neoadjuvant chemoradiation and to assess the relevance of the variation in the levels to therapeutic response. 90 patients with advanced
cancer cervix (FIGO IIIa-IVa) and 90 healthy controls were enrolled. Blood samples were collected: before and after
chemotherapy, after radiation and after 1 year on follow-up. Pro-/
anti-oxidant levels were estimated using standard methods. Response to
therapy was assessed during and after
therapy and after 1 year of follow-up. The pre-treatment levels of plasma
lipid peroxide were significantly elevated; while
antioxidant levels were lowered in
cancer patients; when compared to controls. After
chemotherapy, lipid peroxidation showed a significant decline in complete responders, as compared with partial/non-responders and remained highly significant after
therapy and during follow-up.
Anti-oxidant enzymes showed a mild increase (P < 0.05), after
chemotherapy in complete responders, as compared with partial/non-responders and remained highly significant after
therapy and on follow-up. This important finding suggests that pre-treatment levels of
antioxidant-
oxidant parameters and the extent of their change during treatment can predict the therapeutic response to
neoadjuvant chemoradiation in advanced
cancer cervix.
Oxidant-
antioxidant profile merits investigation as markers of response, survival, and recurrence in larger prospective studies, which might throw light on their possible use as predictors of chemoradiosensitivity of cervical
tumors.