To compare the antioxidant status of cervical cancer patients with healthy controls and to assess the antioxidant levels before and after radiotherapy or radiochemotherapy
Methods and study design
Antioxidant levels (glutathione, glutathione peroxidase, superoxide dismutase, and malondialdehyde) were measured in 35 patients with cervical cancer and 35 age-matched healthy controls. Blood samples were collected twice (before and after treatment) from cervical cancer patients and once from healthy control subjects.
Results
In the patient group, pre-radiotherapy glutathione and glutathione peroxidase levels were significantly lower (P<0.01 and P<0.0001, respectively) than the control group. Pre-radiotherapy levels of superoxide dismutase were significantly higher in cancer patients (P<0.01). In general, no difference was observed between pre- and post-radiotherapy antioxidant levels in cancer patients. However, when post-radiotherapy glutathione levels were analyzed, patients who did not respond to treatment had significantly higher levels than those who did respond (P <0.01).
Conclusions
Levels of antioxidants significantly differed between the patients with cervical cancer and the controls, and no change in antioxidant levels was observed after treatment. Moreover, further studies evaluating the predictive value of glutathione levels on treatment response are warranted.
ParkinD.M., BrayF., FerlayJ., PisaniP.: Global cancer statistics, 2002.CA Cancer J Clin, 55: 74–108, 2005.
2.
EifelP.J., BurkeT.W., DelclosL., WhartonJ.T., OswaldM.J.: Early stage I adenocarcinoma of the uterine cervix: treatment results in patients with tumors less than or equal to 4 cm in diameter.Gynecol Oncol, 41: 199–205, 1991.
3.
Meta-Analysis Group, Medical Research Council ClinicalTrials Unit, London, UK:Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: a systematic review and meta-analysis of individual patient data from 18 randomized trials.J Clin Oncol, 26: 5802–5812, 2008.
4.
CookJ.A., GiusD., WinkD.A., KrishnaM.C., RussoA., MitchellJ.B.: Oxidative stress, redox, and the tumor microenvironment.Semin Radiat Oncol, 14: 259–266, 2004.
5.
ManjuV., Kalaivani SailajaJ., NaliniN.: Circulating lipid peroxidation and antioxidant statusincervical cancer patients: a case-control study.Clin Biochem, 35: 621–625, 2002.
6.
Dalle-DonneI., RossiR., GiustariniD., MilzaniA., ColomboR.: Protein carbonyl groups as biomarkers of oxidative stress.Clin Chim Acta, 329: 23–38, 2003.
7.
ManoharanS., KolanjiappanK., KayalvizhiM.: Enhanced lipid peroxidation and impaired enzymic antioxidant activities in the erythrocytes of patients with cervical carcinoma.Cell Mol Biol Lett, 9: 699–707, 2004.
8.
NairU., BartschH., NairJ.: Lipid peroxidation-induced DNA damage in cancer-prone inflammatory diseases: a review of published adduct types and levels in humans.Free Radic Biol Med, 43: 1109–1120, 2007.
9.
PanayiotidisM.: Reactive oxygen species (ROS) in multistage carcinogenesis.Cancer Lett, 266: 3–5, 2008.
10.
GokulS., PatilV.S., JailkhaniR., HallikeriK., KattappagariK.K.: Oxidant-antioxidant status in blood and tumor tissue of oral squamous cell carcinoma patients.Oral Dis, 16: 29–33, 2010.
11.
KacakciA., AslanI., ToplanS., OysuC., AslanO., AydemirB.: Significance of the counteracting oxidative and antioxidative systems in the pathogenesis of laryngeal carcinoma.J Otolaryngol Head Neck Surg, 38: 172–177, 2009.
12.
BadjatiaN., SatyamA., SinghP., SethA., SharmaA.: Altered antioxidant status and lipid peroxidation in Indian patients with urothelial bladder carcinoma.Urol Oncol, 28: 360–367, 2010.
13.
ShepherdJ.H.: Cervical and vulva cancer: changes in FIGO definitions of staging.Br J Obstet Gynaecol, 103: 405–406, 1996.
14.
CoxJ.D., StetzJ., PajakT.F.: Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC).Int J Radiat Oncol Biol Phys, 31: 1341–1346, 1995.
15.
AmesB.N., GoldL.S., WillettW.C.: The causes and prevention of cancer.Proc Natl Acad Sci USA, 92: 5258–5265, 1995.
16.
HimmetogluS., DincerY., ErsoyY.E., BayraktarB., CelikV., AkcayT.: DNA oxidation and antioxidant status in breast cancer.J Investig Med, 57: 720–723, 2009.
17.
AhmedM.I., FayedS.T., HosseinH., TashF.M.: Lipid peroxidation and antioxidant status in human cervical carcinoma.Dis Markers, 15: 283–291, 1999.
18.
MukundanH., BahadurA.K., KumarA., SardanaS., NaikS.L., RayA., SharmaB.K.: Glutathione level and its relation to radiation therapy in patients with cancer of uterine cervix.Indian J Exp Biol, 37: 859–864, 1999.
19.
SharmaA., RajappaM., SaxenaA., SharmaM.: Antioxidant status in advanced cervical cancer patients undergoing neoadjuvant chemoradiation.Br J Biomed Sci, 64: 23–27, 2007.
20.
WozniakB., Mila-KierzenkowskaC., Kedziora-KornatowskaK., DrewaT., DrewaG., WozniakA., Krzyzynska-MalinowskaE., MakarewiczR.: Influence of the management of cervical carcinoma on the activity of catalase and glutathione peroxidase in erythrocytes.Eur J Gynaecol Oncol, 28: 461–463, 2007.
21.
Mila-KierzenkowskaC., Kedziora-KornatowskaK., WozniakA., DrewaT., WozniakB., DrewaS., Krzyzynska-MalinowskaE., MakarewiczR.: The effect of brachytherapy on antioxidant status and lipid peroxidation in patients with cancer of the uterine cervix.Cell Mol Biol Lett, 9: 511–518, 2004.
22.
BalasubramaniyanN., SubramanianS., GovindasamyS.: Status of antioxidant systems in human carcinoma of uterine cervix.Cancer Lett, 87: 187–192, 1994.
23.
BhuvarahamurthyV., BalasubramanianN., GovindasamyS.: Effect of radiotherapy and chemoradiotherapy on circulating antioxidant system of human uterine cervical carcinoma.Mol Cell Biochem, 158: 17–23, 1996.
24.
KasapovicJ., PejicS., TodorovicA., StojiljkovicV., PajovicS.B.: Antioxidant status and lipid peroxidation in the blood of breast cancer patients of different ages.Cell Biochem Funct, 26: 723–730, 2008.
25.
Gonzalez-GarciaJ.A., NevadoJ., Garcia-BerrocalJ.R., Sanchez-RodriguezC., TrinidadA., SanzR., Ramirez-CamachoR.: Endogenous protection against oxidative stress caused by cisplatin: role of superoxide dismutase.Acta Otolaryngol, 130: 453–457, 2010.
26.
AlexeyevM.F.: Is there more to aging than mitochondrial DNA and reactive oxygen species?FEBS J, 276: 5768–5787, 2009.
27.
JadhavG.K., BhanumathiP., Uma DeviP., SeetharamaiahT., VidyasagarM.S., RaoK.K., HospetC.S., SolomonJ.G.: Possible role of glutathione in predicting radiotherapy response of cervix cancer.Int J Radiat Oncol Biol Phys, 41: 3–5, 1998.
28.
VidyasagarM.S., KodaliM., Prakash SaxenaP., UpadhyaD., Murali KrishnaC., VadhirajaB.M., FernandesD.J., Bola SadashivaS.R.: Predictive and prognostic significance of glutathione levels and DNA damage in cervix cancer patients undergoing radiotherapy.Int J Radiat Oncol Biol Phys, 78: 343–349, 2010.
