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Volume 17, Number 1, 2012

Investigating micronucleus assay applicability for prediction of normal tissue intrinsic radiosensitivity in gynecological cancer patients

Elitsa Encheva, Sofia Deleva, Rositsa Hristova, Valeria Hadjidekova, Tatiana Hadjieva


Background: Pelvic organs morbidity after irradiation of cancer patients remains a major
problem although new technologies have been developed and implemented. A relatively
simple and suitable method for routine clinical practice is needed for preliminary assessment
of normal tissue intrinsic radiosensitivity. The micronucleus test (MNT) determines
the frequency of the radiation induced micronuclei (MN) in peripheral blood lymphocytes,
which could serve as an indicator of intrinsic cell radiosensitivity.
Aim: To investigate a possible use of the micronucleus test (MNT) for acute radiation mor-
bidity prediction in gynecological cancer patients.
Materials and methods: Forty gynecological cancer patients received 50 Gy conventional exter-
nal pelvic irradiation after radical surgery. A four-field “box” technique was applied with 2D
planning. The control group included 10 healthy females.
Acute normal tissue reactions were graded according to NCI CTCAE v.3.0. From all reaction
scores, the highest score named “summarized clinical radiosensitivity” was selected for a
statistical analysis.
MNT was performed before and after in vitro irradiation with 1.5 Gy. The mean radiation
induced frequency of micronuclei per 1000 binucleated cells (MN/1000) and lymphocytes
containing micronuclei per 1000 binucleated cells (cells with MN/1000) were evaluated for
both patients and controls.
An arbitrary cut off value was created to pick up a radiosensitive individual: the mean
value of spontaneous frequency of cells with MN/1000 ±2SD, found in the control group.
Both mean spontaneous frequency of cells with MN/1000 and MN/1000 were registered to
be significantly higher in cancer patients compared to the control group (t = 2.46, p = 0.02 and
t = 2.51, p = 0.02). No statistical difference was registered when comparing radiation induced
MN frequencies between those groups. Eighty percent (32) of patients developed grade 2 summarized clinical radiosensitivity, with great variations in MNT parameters. Only three patients with grade 2 “summarized clinical radiosensitivity” had values of cells with MN/1000 above the chosen radiosensitivity threshold.
Conclusion: The present study was not able to confirm in vitro MNT applicability for radiosen-
sitivity prediction in pelvic irradiation.

Signature: Rep Pract Oncol Radiother, 2012; 17(1) : 24-31

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