A COMPARATIVE EVALUATION OF ENZYMATIC ANTIOXIDANT LEVELS IN PRE AND POST THERAPY PATIENTS WITH ORAL CANCER
Keywords:
Oral Cancerr, Oxidative stress, Antioxidant enzymes, Chemo and radiotherapy, Superoxide dismutase, Glutathione Peroxidase, CatalaseAbstract
Objectives: The present study was aimed to evaluate the magnitude of oxidative stress and levels of enzymatic antioxidants in Oral Squamous cell carcinoma (OSCC) patients receiving radiotherapy (RT) and chemo radiotherapy (CRT). Venous blood samples were collected from 20 healthy subjects, 20 disease control patients (without treatment), 20 oral cancer patients who received chemo radiotherapy and 20 oral cancer patients receiving radiotherapy and were analyzed for antioxidant status using various assay techniques.
Methods: The present study measured the levels of three antioxidants enzymes: Superoxide dismutase (SOD), Glutathione Peroxidase (GPX), Catalase (CAT) in the plasma samples of 20 patients who were proven with biopsy-Squamous cell carcinoma of the oral cancer with clinical stage III/IV and were receiving radio and chemo radiotherapy. Same enzymes were also estimated in 20 healthy individuals and disease control patients (who were admitted in to the cancer clinic).
Results: The plasma levels of antioxidant enzymes (SOD, CAT, and GPX) were lower in the oral cancer patients as compared to those in the healthy individuals. Superoxide dismutase levels in healthy control patients were found to be 190.4µg/dl, 34.54 µg/dl in disease control patients, 46.16 µg/dl in radiotherapy received group patients and 81.48 µg/dl in chemo and radiotherapy received group patients. Glutathione peroxidase levels were found to be 65.713 µg/dl in healthy control group patients, 13.8 µg/dl in disease control patients, 16.49 µg/dl in radiotherapy received group patients, 34.2 µg/dl in chemo and radiotherapy received group patients. Catalase enzyme levels were found to be 52.37 µg/dl in healthy control group patients, 12.35 µg/dl in disease control group patients, 22.34 µg/dl in radiotherapy received group patients, 27.18 µg/dl inchemo and radiotherapy received group patients. These enzymes also showed significant changes with radiotherapy and chemoradiotherapy. Antioxidant enzymes in the plasma of the oral cancer patients after radiation therapy lowered as compared to the plasma levels of enzymes after chemoradiotherapy.
Conclusion: This present study also showed decreased levels of antioxidant enzymes in the plasma of the oral cavity cancer patients after radiation therapy as compared to the chemoradiotherapy receiving oral cancer patients. An appreciable progress in antioxidant levels were observed in patients after receiving chemoradiotherapy (CRT) and observed to be more effective than after radiotherapy (RT). The reason for this observation was believed that concomitant chemoradiation and radiotherapy caused a reduction in the lipid peroxidation process and an improvement in the antioxidant levels of the oral cancer patients. But the radiation therapy produces high oxidative stress when compared to chemoradiotherapy in Oral Squamous Cell Carcinoma.
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References
Parkin DM, Pisani P, Ferlay J. Estimates of the worldwide incidence ofeighteen major cancers in 1985. Int J Cancer 1993;54:594–605.
Posner M. Head and neck cancer. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007. p. 200.
Wein RO, Malone JP, Weber RS. Malignant neoplasms of the oral cavity. In: Flint PW, Haughey BH, Lund VJ, eds. Cummings Otolaryngology Head and Neck Surgery. 5th ed. St. Louis, Mo: Mosby Elsevier; 2010. p. 96.
Kotwall C, Razack MS. Sako K, Rao U. Multiple primary cancers in squamous cell cancers of the head and neck. I Surg Oncol 1990;40:97-9.
Khalili J. Oral cancer: risk factors, prevention and diagnostic. Exp Oncol 2008;30:259-64.
Mayne S, Morse D, Winn D. Cancers of the oral cavity and pharynx. In: Schottenfeld D, Fraumeni J, Jr, editors. Cancer epidemiology and prevention. 3rd ed. New York: Oxford University Press; 2006. p. 674–96.
Adelstein DJ, Li Y, Adams GL. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol 2003;21:92–8.
Ang KK, Garden AS. Radiotherapy for head and neck cancers: indications and techniques. Philadelphia: Lippincott Williams and Wilkins; 2006.
Anneroth G, Batsakis J, Luna M. Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas. Scand J Dent Res 1987;95:229–49.
Bagan J, Sarrion G, Jimenez Y. Oral cancer: clinical features. Oral Oncol 2010;46:414–7.
Sun Y, Oberley LW, Li Y. A Simple method for clinical assay of superoxide dismutase. Clin Chem 1988;34:497‑500.
Misra HP, Fridovich I. The role of superoxide anion in the autoxidation of epinephrine and a simple assay for superoxide dismutase. Biol Chem 1972;247:3170–5.
Antoniades DZ, Styanidis K, Papanayotou P. Squamous cell carcinoma of the lips in a northern Greek population. Evaluation of prognostic factors on 5-year survival rate—I. Eur J Cancer B Oral Oncol 1995;31B:333–9.
Shubha Gurudath, Raghavendra Mahadev Naik, Ganapathy KS, Yadavalli Guruprasad, Sujatha D, Anuradha Pai. Superoxide dismutase and glutathione peroxide in oral submucous fibrosis, oral leukoplakia, and oral cancer: A comparative study. J Clin Oncol 2012;4:114-9.
John P, Richie Jr, Wayne Kleinman, Patricia Marina, Patricia Abraham, Ernst L Wynder, et al. Muscat Blood iron, glutathione and micronutrient levels and the risk of oral cancer and premalignancy. Nutr Cancer 2008;60(4):474-82.
Paglia DE, Valentine WN. Studies on quantitative and qualitative characterization of erythrocyte glutathione peroxidase. Ann Biochem 1986;16:359‑64.
Greenwald RA. Superoxide dismutase and catalase as therapeutic agents for human diseases; a critical review. Free Radic Biol Med 1990;8:201-9.
Stewart BW, Kleihues P, editors. World cancer report. Lyon: WHO International Agency for Research on Cancer; 2003.
Goldberg Z, BE Lehnert. Radiation-induced effects in unirradiated cells: a review and implications in cancer. Int J Oncol 2002;21:337–49.
Bernier J, Domenge C, Ozsahin M. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 2004;350:1945–52.
Steward L. Dietary antioxidant intakein patients at risk for second primary cancer. Laryngoscope 2003;113(9):1487-93.
M Valko, M Izakovic, M Mazur, CJ Rhodes, J Telser. Role of oxygen radicals in DNA damage and cancer incidence. Mol Cell Biochem 2004;266:37–56.
Weijl NI, Hopman GD, Wipkink-Bakker A. Cisplatin combination chemotherapy induces a fall in plasma antioxidants of cancer patients. Ann Oncol 1998;9:1331–7.