Serum Level of Vascular Endothelial Growth Factor (VEGF) can be used to Assess Response of Radiation Therapy in Cervical Cancer

Abstract

Objective: To compare the sensitivity and specificity of Squamous Cell Carcinoma (SCC) and Vascular Endothelial Growth Factor (VEGF) levels to assess the response of radiation therapy.
 Method: The study was conducted by the method of analytic observational cohort study in 24 patients with cervical cancer stage II-B and III-B in RSCM that met inclusion criteria. Examination of VEGF and SCC in serum samples was performed in the Prodia Laboratory Jakarta. The examination was conducted twice before and after radiation therapy. The subjects were treated by radiation therapy/chemoradiation according to standard procedures. After the completion of radiation was declared, the response of radiation therapy was conducted by clinical assessment.
 Result: Of the 24 subjects, we obtained a mean level of SCC pre-radiation was 23.43 ± 5.84 ng/ml and post-radiation was 2.19 ± 0.68 ng/ml. The mean VEGF pre-radiation was 790.41 ± 111.06 pg/ml and post-radiation was 497.47 ± 79.26 pg/ml. ROC curves of each tumor marker obtained SCC pre-radiation AUC 40%, p 0.53 (CI 0.18-0.68) and SCC post-radiation AUC 48.1%, p 0.91 (CI 0.21-0,75) can not be used as a diagnostic and prognostic factors of response to radiation therapy. VEGF pre-radiation produced an AUC of 17.5%, p 0.04 (CI 0.00-0.36), thus cannot be used as a prognostic factor for response to radiation therapy. VEGF after radiation produced an AUC of 92.5%, p 0.01 (CI 0.81-1.00), thus can be a diagnostic factor for response to radiation therapy. VEGF post-radiation with cut-off point 614.75 pg/ml had a sensitivity 80%, specificity 75%, NDP 94.12%, NDN 42.86%; RKP 3.2; RKN 0.26 and accuracy 79.16%. There is a significant correlation between the decrease of serum VEGF level post-radiation and a positive response of radiation therapy (p 0.01, CI 1.00-3.23).
 Conclusion: Examination of VEGF levels can be used to assess the response of radiation therapy with a sensitivity of 80% and specificity of 75%. 
 Keywords: cervical cancer, SCC, therapeutic response, VEGF

Association of Vascular Endothelial Growth Factor (VEGF) and Mammalian Target of Rapamycin (mTOR) with Radiotherapy Response in High-Grade Sarcomas

“…This result indicated that both VEGF and mTOR expression were upregulated in the radioresistance of high-grade sarcoma and might contribute to radioresistance in high-grade sarcoma. The result of this study is consistent with the study performed by Wibisono et al [9] and Armanza et al [17] that describe a significant correlation of VEGF overexpression with radioresistance in cervical carcinoma [9]. Similarly, the result of this study was also observed in the study performed by Kim et al [10] that described a significant correlation of mTOR overexpression with radioresistance in cervical carcinoma.…”

Relationship between Serum Vascular Endothelial Growth Factor-A Levels and Response to Chemotherapy in Cervical Cancer

“…The results of this examination are by Armanza research, et al (5) who stated that there was a significant correlation between decreased serum VEGF levels after therapy with positive radiation response (p=0,01). Postradiation VEGF can be a demonstrative calculation of the reaction to radiation treatment in cervical malignant growth.…”

“…One way to assess the response to chemotherapy treatment is tumor marker examination. (5) Vascular Endothelial Growth Factor-A (VEGF-A) is a significant biomarker that is a key signal that causes tumor angiogenesis, namely the process of forming new blood vessels in tumors that originate from blood vessels that already exist in the body. thereby helping the growth and spread of tumors.…”

“…(6,7,8) Past exploration expressed that checking VEGF levels can be utilized to evaluate the reaction to radiation treatment with a responsiveness of 80 % and a particularity of 75 %. (5) The benefit of using a serum VEGF biomarker is that it takes samples non-invasively from the patient and can see changes in the VEGF biomarker by repeating the test during treatment. (8) Based on these data, This study aims to analyze the relationship between serum VEGF-A levels and the response to neoadjuvant chemotherapy in cervical cancer patients.…”