Interfacial properties as predictors of radioresistance in cervical cancer

The prediction of radioresistance of tumours, early in the course of radiotherapy, may help clinicians in deciding the optimal treatment strategy for each case. This study was carried out to investigate an in vitro technique to predict radiosensitivity, after a single radiation dose of 2 Gy in cervical cancer. Langmuir films of tissue homogenates of biopsy samples from 20 cervical cancer patients treated with radiotherapy alone and 15 normal controls were evaluated. The tensiometric profiles before and after giving 2 Gy of radiation, were compared with that of controls and were correlated with the clinical radioresponsiveness evaluated on completion of the radiotherapy course of 70-78 Gy over a period of 50-55 days. The tensiometric profiles measured after a single dose of radiation can be used to fingerprint the clinical radioresponsiveness of the cervical cancer tissues. The hysteresis of the monolayers of completely radioresponsive post-radiotherapy tissue homogenates was 5.8 times greater than that of partially radioresponsive post-radiotherapy tissue homogenates and was statistically significant using Mann-Whitney test (p<0.05). From our results, the following tensiometric criteria for prediction of radioresistance emerge. After first dose of radiation, if the minimum surface tension of tissue homogenate is greater than 50 mN/m and hysteresis area is less than 20 microJ those tissues will be in the partially radioresponsive and for completely radioresponsive tissue homogenates, the minimum surface tension will be less than 47 mN/m and the hysteresis area will be greater than 33 microJ. The cholesterol and phospholipid content of radioresponsive cervical cancerous tissues after radiotherapy was found to be 1.2 and 2.2 times lower than that of the untreated tissues and due to lower lipid content organic phase surface activity of radioresponsive cancerous tissues after radiotherapy was less than that of the untreated tissue organic phase. The radiation induced tensiometric profile changes of radioresponsive cervical cancerous tissues can be correlated to the radiation induced lipid profile changes. This technique, due to its simplicity and high precision, can serve as a predictive tool for radioresponsiveness and is easily translatable to the clinical setting. Randomized large sample trials are necessary to validate this technique further and help in the translation from bench to clinics.