Nuclear morphometry as a predictor of response to neoadjuvant chemotherapy plus radiotherapy in locally advanced...

We have studied nuclear morphometric characteristics from H & E slides of 23 patients with locally advanced squamous cell carcinoma of the cervix treated with neoadjuvant chemotherapy (cis-platinum + 5-fluorouracil) plus radiation therapy to see if a correlation existed between these morphometric assessments and response to chemotherapy/radiotherapy. On the same 23 patients, biopsies were taken at three times: before treatment, after chemotherapy alone, and after chemotherapy plus radiation therapy. Using the Zeiss Videoplan III morphometric workstation, tumor nuclear area and nuclear roundness factor were assessed on three different tumor cell populations: the basal, intermediate, and superficial cell layers. There were two principal results from this study: (1) There was a significant (P = 0.007) reduction in the appearance of the basal layer of tumor cells following chemotherapy. (2) The reduction in nuclear area of intermediate layer tumor cells by chemotherapy alone was significant in responders (P = 0.005) but not in nonresponders (P = 0.74) to the combined therapy. The ability to differentiate between responders and nonresponders to combined therapy after only the chemotherapy has been administered may allow more rational patient selection for radiation therapy.