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A Cohort Study: Caspase-3 As Prognostic Factor of Radiation Therapy in The Advanced Stage of Cervical Cancer (IIB-IIIB) Patients

  • Hermawan Udiyanto ,
  • Ambar Mudigdo ,
  • Sri Sulistyowati ,
  • Bambang Purwanto ,
  • Vitri Widyaningsih ,
  • Brian Wasita ,


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.


  1. Campion MJ, Canfell K. Berek & Hacker’s gynecologic oncology. 2015.
  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.
  3. Ayhan A, Gultekin M, Dursun P. Advanced Cervical Cancer. In: Marnitz S, Kohle C, editors. Textbook of gynaecological oncology. Günes Publishing; 2012.
  4. Edianto D. Kanker Serviks, Buku Acuan Nasional Onkologi Ginekologi, Yayasan Bina Pustaka Sarwono Prawiroharjo. Edisi Pertama, Cetakan Pertama, Jakarta; 2006.
  5. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228–47.
  6. Elmore S. Apoptosis: a review of programmed cell death. Toxicol Pathol. 2007;35(4):495–516.
  7. Yamashita H, Nishio M, Toyama T, Sugira H, Zhang Z, Kobayashi S, et al. Coexistensi of HERE2 Over-Expressing and p53 Protein Accumulation is a Strong Prognostic Molecular Marker in Breast Cancer. Am J Pathol. 2004;164(3):1031–8.
  8. Jakubowska K, Guzińska‑Ustymowicz K, Famulski W, Cepowicz D, Jagodzińska D, Pryczynicz A. Reduced expression of caspase-8 and cleaved caspase-3 in pancreatic ductal adenocarcinoma cells. Oncol Lett. 2016;11(3):1879–84.
  9. Liu P-F, Hu Y-C, Kang B-H, Tseng Y-K, Wu P-C, Liang C-C, et al. Expression levels of cleaved caspase-3 and caspase-3 in tumorigenesis and prognosis of oral tongue squamous cell carcinoma. PLoS One. 2017;12(7).

How to Cite

Udiyanto, H., Mudigdo, A., Sulistyowati, S., Purwanto, B., Widyaningsih, V., & Wasita, B. (2020). A Cohort Study: Caspase-3 As Prognostic Factor of Radiation Therapy in The Advanced Stage of Cervical Cancer (IIB-IIIB) Patients. Bali Medical Journal, 9(2), 501–503.




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