The Correlation Between Tumor Angiogenesis and the Effect of Radiation Therapy in Cervical Cancer Patients

Carcinoma of the uterine cervix is a serious health problem. Cervical cancer is the most common malignant neoplasm of women in Taiwan. There were 2,720 new cases of invasive carcinoma of the cervix and 971 deaths from the disease in 2000. Cervical cancer is indeed is an important disease in Taiwan.

The primary therapies for cervical cancer are surgery, radiotherapy or chemoradiotherapy. Several clinical trials have showed that an improvement in time to progression and survival for patients given chemoradiotherapy compared with radiotherapy alone. Chemoradiotherapy is now regarded as standard modality to treat the locally advanced (stage IIB–IVA) or high-risk early-stage cervical cancer. However, some of the cervical cancer patients still failed to response to the treatment of cervical cancer or relapsed for completion of treatment.

Angiogenesis plays an important role in the pathogenesis of cancer. Recent studies have related angiogenesis to cancer growth and metastasis Ultrasonography has been used in the gynecologic field for decades. The previous studies of our team have shown that incremental angiogenesis could be demonstrated in the tumorigenesis of ovarian, endometrial malignancies, and cervical caner. Besides, other growth factors such as vascular endothelial growth factor (VEGF), and IL-6 have also been reported to correlate with the angiogenesis and the prognosis of cervical cancer. It seems that tumor angiogenesis could be utilized as a good marker to survey the severity of disease and prognosis of early-staged cervical cancer patients.

There is no good method or marker which could be utilized to monitor the response of radiotherapy and evaluate the prognosis of cervical cancer patients with advanced stages. So we would like to propose this proposal to focus on the tumor angiogenesis in cervical cancer patients with advanced stages. There are several purposes in this study. First, we will evaluate the kinetic changes of tumor angiogenesis in cervical cancer patients who receive radiotherapy or concurrent chemoradiotherapy. Second, we will evaluate that if the tumor angiogenesis could be a marker to monitor the response of radiotherapy or chemoradiotherapy in cervical cancer patients. The relation between tumor angiogenesis and radiotherapy will be explored and clarified by this study. The comprehensive role of tumor angiogenesis in cervical cancer will be elucidated by the results of this study.