Background: Sarcoma is a rare malignant aggressive tumor originating from mesenchymal elements. High-grade sarcoma has a poor prognosis. The mortality rate of high-grade sarcomas is 50–75%. Radiotherapy is needed in high-grade sarcoma. Radioresistance in the high-grade sarcoma is still common. Vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) are molecular markers that play a role in radioresistance. This study aimed to analyze the association of VEGF and mTOR with radiotherapy response in high-grade sarcoma. Method: This study was an analytic observational study with a cross-sectional design. The minimum samples based on Lameshow’s formula included 40 selected paraffin-embedded tissue blocks from biopsy high-grade sarcoma, consisting of 20 samples of radioresistance and 20 samples of radiosensitive. Immunohistochemistry staining for VEGF and mTOR were performed on all samples. Statistical analysis used the Chi-Square test. The significance of the data was obtained when p-value <0.05.Result: High immunoexpression of VEGF (OR = 17, p < 0.05) and mTOR in high-grade sarcoma showed a significant association with radiotherapy response (OR = 16, p < 0.05). The stepwise logistic regression analysis revealed that both VEGF and mTOR immunoexpression influenced radiotherapy response simultaneously. Conclusion: In this study, which used a minimum sample, it can be concluded that the higher VEGF and mTOR immunoexpression showed the higher radioresistance in high-grade sarcoma.
BackgroundSarcomas are rare, aggressive tumors originating from mesenchymal tissue. Radiotherapy is currently accepted as thestandard adjuvant to the treatment of high-grade sarcomas, whereas low-grade sarcomas are controversial, but the response ofradiotherapy to sarcomas is up to 50%. The aim of this study was to determine the association between the histopathologicalgrade of sarcoma and the radiotherapeutical response.MethodsThe research design was a cross-sectional study, with retrospective analysis. The sample consisted of 80 paraffin block tissuesfrom biopsy and surgery specimens of sarcoma from January 2013 to December 2019 at Hasan Sadikin Hospital in Bandung,consisting of 45 radiosensitive samples and 35 radioresistant samples. All samples were assessed for histopathological gradeaccording to the FNCLCC. Statistical analysis used the Chi-Square test with a significant value of p <0.05. Data were processedusing SPSS version 24.0 for windows.ResultsIn the radiosensitive group, 15 (33.3%) samples were low grade sarcomas and 30 (66.7%) samples were high grade sarcoma.There was no statistically significant association between histopathological grade and radiotherapeutical response in sarcomasp> 0.05 (p = 0.304).ConclusionIn this study, the radiotherapeutical response was not associated to the histopathological grade of sarcoma. This is because ofthe sensitivity of radiotherapy is influenced by other factors including molecular characteristics.
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