A cohort study: Caspase-3 as prognostic factor of radiation therapy in the advanced stage of cervical cancer (iib-iiib) patients

Background: The treatment of the advanced stage of cervical cancer (stage IIB, IIIB) using internal (brachitherapy) and external radiation therapy raises question in how to determine the prognosis of the disease. The role of caspase 3 in predicting radiation response in the advanced stage of the cervical cancer (stage IIB-IIIB) is still unknown. This study aim to analyze the role of Caspase-3 expression as a prognostic factor of radiotherapy in patients with the advanced stage cervical cancer. Methods: This study is an analytical cohort prospective study from June 2019 to February 2020 in the Department of Obstetrics and Gynecology in association with the Department of Anatomic Pathology of Dr. Moewardi General Hospital, Surakarta, Indonesia involving 40 patients diagnosed with cervical cancer. The staging of cervical cancer was determined using the FIGO 2019 staging system. The Caspase-3 expression level were determined using immunohistochemical examination. The association between the caspase 3 expression and changes of tumor volume is analyzed using chi square and fisher exact test for parametric and non-parametric test, respectively. A p-value of less than 0.05 is considered to be statistically significant. Results: The analysis shows that there is a significant association between the Caspase-3 expression and the changes of tumor volume (p = 0.04). The odds of the changes of tumor volume in the score 3 of the caspase-3 expression is 22.67 times higher than the score 2 of the caspase-3 expression (95%CI, 1.56-328.95, p=0.04). Conclusion: Caspase-3 expression has a significant association with the changes in the tumor volume of the advanced stage cervical cancer.