NUCLEAR MORPHOMETRY AS A PREDICTOR OF RESPONSE TO NEOADJUVANT CHEMOTHERAPY PLUS RADIOTHERAPY IN LOCALLY ADVANCED CERVICAL-CANCER

We have studied nuclear morphometric characteristics from H & E slides of 23 patients with locally advanced squamous cell carcinoma of the c enix treated with neoadjuvant chemotherapy (cis-platinum + 5-fluoroura cil) plus radiation therapy to see if a correlation existed between th ese 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 radia tion 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 superf icial 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 reducti on in nuclear area of intermediate layer tumor cells by chemotherapy a lone was significant in responders (P = 0.005) but not in nonresponder s (P = 0.74) to the combined therapy. The ability to differentiate bet ween responders and nonresponders to combined therapy after only the c hemotherapy has been administered may allow more rational patient sele ction for radiation therapy. (C) 1994 Academic Press, Inc.