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BACKGROUND: Due to the aggressive nature of head and neck cancer, radiation therapy (RT) with chemotherapy has become an established integral modality in the management of this malignancy. Although employed to improve quality of life, its association with several side effects remains a clinical threat. Matrix metalloproteinase-1 (MMP-1) degrades most extracellular matrix proteins, one of which is collagen. Found to increase in the occurrence of cancer, further rise ensues when exposed to radiotherapy and chemotherapy. This dissolution is a key event of invasion and metastasis of malignant lesions of the head and neck.
OBJECTIVE: To assess the adverse effects of site-directed radiation therapy in relation to the significant change in the level of Matrix Metalloproteinase-1 (MMP-1) on selected head and neck carcinoma patients.
METHODS: This is an observational longitudinal approach study on 20 head and neck cancer patients from Jose R. Reyes Memorial Medical Center. Expression of MMP-1 levels in the plasma samples of Day 0 and Day 10 was determined by the use of enzyme-linked immunosorbent assay (ELISA). Oral mucositis (OM), a radiation-induced toxicity, was evaluated using the Radiation Therapy Oncology Group (RTOG) grading system. Correlation between MMP-1 level and complete blood count (CBC) of carcinoma patients was also included in the study.
RESULTS: The expression of MMP-1 level exhibited an increasing trend from Day 0 to Day 10. However, obtained p-value (0.148) presented a statistically insignificant correlation between MMP-1 level and site-directed radiation therapy. The RTOG measured OM of cancer patients undergoing site-directed radiation therapy exhibited a statistically significant p-value (0.026) signifying a correlation between OM and MMP-1 levels. Parallel to OM, certain hematological parameters of the CBC such as platelets and leukocytes also showed a significant relationship with levels of MMP-1 (p-values of 0.0099 and 0.0397, respectively).
CONCLUSION: The study results showed the potential role of MMP-1 as a prognostic marker to estimate the chance of recovery from treatment-related side effects of head and neck cancer patients undergoing site-directed radiotherapy.