Oftalmol Zh. 2013;6:44-50.
Estimation of the response of malignant epithelial tumors of the eyelid skin to the radiation the first stage of radiocryogenic treatment
Vit VV, Safronenkova IA
SI «The Filatov Institute of Eye Diseases And Tissue Therapy NAMS of Ukraine», Odessa
Introduction. The response of a tumour (TR) to radiation influence represents a complex of the alternative — destructive changes induced by the antineoplastic therapy in the tumor. Its estimation is important for determination of efficiency of antineoplastic therapy and helps to lead a part of patients with initially inoperable tumours up to resectable status. Reduction of the tumour size during radiation therapy (RT) is considered as a sign of its radiosensitivity and important prognostic factor.
Purpose. To study clinical, histologic and immunohistochemical indices of TR of malignant epithelial tumours (MET) of the eyelid skin at the stage of RT in radiocryogenic treatment.
Materials and methods. 226 patients with MET of the eyelid skin of the stage T2a-3b N0 M0 at the stage of RT are investigated in radiocryogenic treatment in ophthalmooncologic center of SI«The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine» for the period from 1998 to 2008. The estimation of TR degree on RT is made by the clinical, histo-morphological (125patients) and immunohistochemical characteristics (by means of monoclonal antibodies p53, Bcl-2, CD95 and IPO 38) in 147 patients.
Results and discussion. In clinical estimation of TR to radiation influence partial regress of the neoplasm was noted in 193 of 226 patients (85.4 %), and in 33 (14.6 %) there were no changes of the size of the tumour, that is a part of tumours has appeared to be radiosensitive, and a part — radioresistant. In radiosensitive tumours the local control has appeared 1.5 times better than in radioresistant ones though these distinctions are not significant (%2—1.96, p = 0.65). After radiocryogenic treatment relapses of MET of the eyelid were observed 45 times more often in radioresistant tumours. In histomorphologic estimation of TR to RT there was noted a change of histologic type of the tumour, BCC was transformed into EC (5 cases) and MTC (8cases). Similar anaplasia 5.5 times was more often observed in the group of radioresistant tumours (%2 =87.5, p = 0.0005). The expressed polymorphism of tumours structure in various sites of the tumour is revealed in both groups and differed by the degree of radiation damages. In immunohistochemical TR of MET of the eyelid skin there was observed reliable (% =8.1, p = 0.02) reduction in the level of CD95 (+) expression in radioresistant tumours. In radio-sensitive tumours the tendency to reduction in the level of the antiapoptotic protein Bc1—2 is noted. In both groups the tendency to increase of the proliferative activity is noted due to the antigene, associated with proliferation and revealed by means of MKAT IPO 38.
Key words: malignant epithelial tumours of the eyelid skin, response of the tumour to radiation therapy, markers p53, Bc1-2, C095, IPO38
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