Abstract
Pelvic intensity-modulated radiation therapy (IMRT) combined with concurrent chemotherapy is an effective treatment for cervical cancer; however, radiation resistance impairs its clinical benefit. The vaginal microbiome plays an important but poorly understood role in cancer radiochemotherapy. In this study, we investigated the effects of treatment on the overall composition and alteration of the vaginal microbiome in patients receiving pelvic IMRT with concurrent cisplatin-based chemotherapy. We collected samples from twenty patients with cervical cancer and six healthy controls and performed 16S rRNA sequencing. Vaginal microbial composition analysis revealed significant differences between the two groups, but no significant differences between radiation treatment time points. However, the relative abundances of Gammaproteobacteria, Gemmatimonadetes, Gemmatimonadales, Pseudomonadales, Gemmatimonadaceae, Rikenellaceae, Acinetobacter, Desulfovibrio, Prevotella 9, Rikenellaceae RC9 gut group, Turicibacter, and the metagenome increased with time. The results encourage further study into the effects of the vaginal microbiome on cervical cancer treatment strategies, especially radiochemotherapy. Better understanding of these effects could inform new therapeutic approaches to enhance the efficacy of radiochemotherapy.
Highlights
IntroductionThe most common gynecological malignancy, occurs in the epithelial lining of the cervix [1]
Cervical cancer, the most common gynecological malignancy, occurs in the epithelial lining of the cervix [1]
Cervical cancer often results from persistent infection with human papillomavirus (HPV), which induces cervical epithelial cells to become cancerous [25]
Summary
The most common gynecological malignancy, occurs in the epithelial lining of the cervix [1]. For patients with locally advanced cervical cancer, radiotherapy combined with chemotherapy has become the mainstream treatment, usually involving intensity-modulated radiation therapy (IMRT) [2, 3]. Changes in the vaginal microbiome (VM) are associated with cervical cancer development [6,7,8], and evidence is rapidly mounting that it can affect cancer treatment outcomes through diverse mechanisms [9, 10]. To assess the effects of pelvic radiochemotherapy on the VM, we compared the VM profiles of patients with cervical cancer and healthy controls, and tracked the changes to the VM in patients with cervical cancer during pelvic IMRT combined with concurrent cisplatin-based chemotherapy by bacterial 16S rRNA gene sequencing
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