IGF-1R expression in localized cervical carcinoma patients treated by radiochemotherapy

Abstract

Purpose: To assess the expression of IGF-1R in cervix carcinoma patients treated by radiotherapy and concomitant chemotherapy, its relation to clinical and pathologic prognostic factors and its role in predicting clinical outcome.

Materials and methods: Sixty consecutive patients suffering from localized cervix carcinoma were prospectively included in this study from July 1999 to December 2003. Follow-up was closed in March 2006. Patients were staged following the TNM classification. All patients were referred to pelvic radiation up to doses of 45-64.80 Gy in 1.8-2 Gy fractions followed brachytherapy treatment. External radiotherapy boost was used in one patient not receiving brachytherapy (total dose up to 64.80 Gy). All patients received concomitant cisplatin at 40 mg/m(2)/week doses during pelvic radiation. IGF-1R expression was studied by immunohistochemistry in paraffin-embedded tumor tissue.

Results: IGF-1R was expressed in 56 patients (93.7%) and no relation was found with clinicopathological variables. Complete response after treatment was observed in 50 patients (83.3%). Clinical stage of the disease and clinical response to radiotherapy were the most important prognostic factors related to survival. Low (negative and fairly) IGF-1R tumor expression was correlated to better long-term Local and Regional Disease Free Survival (p=0.045), Disease-Free Survival (p=0.045), Cause-Specific Survival (p=0.032) and Overall Survival (p=0.021) in patients achieving a complete response.

Conclusion: High IGF-1R expression is related with reduced long-term local control due to tumor disease radiochemoresistance in patients who initially respond to definitive radiotherapy and concomitant chemotherapy.