Micronucleus assay in vivo provides significant prognostic information in human cervical carcinoma, the updated analysis

Purpose: Reanalysis after a 5-year follow-up previously presented relations hip between spontaneous and radiation-induced micronucleus frequencies in t umour cells and the clinical outcome of patients with advanced stages (II B IV B) of cervix carcinomas treated with radiotherapy. Materials and methods: Spontaneous and induced in vitro and in vivo micronu cleus frequencies were determined and related to clinical parameters. Data were analysed by the univariate Kaplan-Meier method and multivariate Cox pr oportional hazards model. Results: In univariate analysis stage, spontaneous micronucleus frequency b efore radiotherapy (MNSP) and per cent increment of micronucleus level in v ivo after 20 Gy in relation to spontaneous pretreatment level were statisti cally significant predictors of 5-year recurrence-free, disease-free and ov erall survival. Neither micronucleus frequency (MN/BNC at 2 Gy) nor prolife rating fraction (%BNC at 0 Gy) estimated in vitro (in primary culture) were related to radiotherapy outcome. The age of patients was not associated wi th clinical results. Multivariate analysis demonstrated that the clinical s tage of disease, the high frequency of spontaneous micronuclei and low-indu ced micronucleus frequency were independent and significantly unfavorable p redictive factors for disease-free and overall survival. But for local cont rol, only high MNSP and low-induced MN frequency were significance negative predictive variables. Conclusions: A high frequency of micronuclei before radiotherapy and a slig ht increase if micronucleus frequency during radiotherapy measured after 10 fractions of 2Gy were independent on stage, statistically significant adve rse predictors of clinical outcome in cervical carcinoma patients treated w ith radiotherapy.