Multi-nucleation indices in radiotherapy treated squamous cell carcinoma- a tool in treatment planning and assessment of prognosis

Author: 
Kumar Satish Ravi, Manisha Naithani, Sohinder Kaur, Reddy K.S and Rachna Pasi

Background: Oral cancer ranks as one of the top ten cancers worldwide being the most prevalent cancer in India. Radiotherapy, one of the modality of treatment causes damage to the DNA and target cells through complicated series of atomic interactions. The present study was undertaken with an aim to evaluate the multi-nucleation in malignant cells obtained from the scrapings taken from the site of lesion.

Materials and method: Fifty patients attending outpatient department of JIPMER hospital with histopathologically confirmed Squamous Cell Carcinoma (SCC) of oral mucosa and undergoing radiotherapy alone were included. From all these patients the specimens from the site of lesion was collected on pre-treatment day and subsequently on 2nd, 7th, 12th and 30th day of radiotherapy.

Results: A rise of 45.18% was observed at 4 Gy with peak at 14 Gy as 89.61%, a sudden fall to 27.11% at 24 Gy and a fall of 133.15% in multi-nucleation were observed at 60 Gy. The mean percentage increase when compared with pre-treatment day was statistically significant (p=0.001) for comparison between day 0 (pre-treatment) & day 2, similarly 0 & 7, 0 & 12 and finally 0 & 30.

Conclusion: The progressive increase in Multi-nucleation indices with increasing dose of radiation indicates that this parameter can be used as an indicator for assessing the response of tumour of radiotherapy.

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