The Prognostic and Predictive Value of Expression of P-AKT in Patients with FIGO IIB Locally Advanced Cervical Cancer under Chemotherapy

Abstract

To evaluate the relation between expression of P-Akt and radiotherapy response, disease-free survival and overall survival in cervical cancer patients. A total of 50 patients with FIGO stage IIB locally advanced squamous cell cervical cancer treated primarily with chemoradiotherapy were included in the present study. All patients received external beam radiotherapy (EBRT; 46-50.4 Gy with 1.8-2 Gy of daily fraction, five times a week) followed by high-dose rate brachytherapy (HDR 26 Gy at point A, with 6.5 Gy per fraction a week for 4 weeks). Chemotherapy consisted of 40 mg/m2 cisplatin i.v. once a week for 5 weeks concomitant with external pelvic radiation. Paraffin-embedded, formalin-fixed primary tumor tissue was collected from each patient to identify P-Akt expression, retrospectively. The median follow up time for the study population was 30 (12-120) months. Expression of P-Akt was identified in 86% (43/50) of patients. Overall 3-years survival and disease free survival were 89.3% and 79%; respectively in the study population. There was no significant association between P-Akt staining and survival (89% vs 85.7%, p= 0.641) and disease-free survival (80% vs 88.2%, p= 0.498). There was no relation between expression of P-Akt and treatment response, size of the tumor, lymph node status, age, local and distant failures. Univariate analysis revealed significantly reduced overall 3-years survival and disease free survival only for patients with poor treatment response (p= 0.001). In multivariate analysis, treatment response was found to be statistically significant parameter only for DFS (p= 0.001). In conclusion, in our study, expression of P-Akt was detected in majority of cervical cancer patients. However no correlation was observed between P-Akt staining degree and treatment response