Interstitial Hypertension in Carcinoma of Uterine Cervix in Patients: Possible Correlation with Tumor Oxygenation and Radiation Response

Elevated tumor interstitial fluid pressure (IFF) is believed to be responsible, at least in part, for the poor penetration and heterogeneous distribution of blood-borne therapeutic agents and nutrients in solid tumors. Using the wick-in-needle technique, IFF was measured in human patients with squamous cell carcinoma of the uterine cervix at the initial and final stages of fractionated external beam radiotherapy. Mean IFF values ranged from 10 to 26 mm Hg with an overall mean of 15.7 ±5.7 (SD) mm Hg in stage IIB and IIIB tumors (n = 12) and from 0 to 3 mm Hg in normal cervix (n = 3). IFF decreased in some patients with therapy while in others it increased. The changes in IFF values agree well with the clinical response to radiotherapy (n = 7, P < 0.05). Oxygen tension, measured in selected tumors (n = 3) with polarographic oxygen microelectrodes, inversely correlated with IFF. These results show for the first time that the IFF in human cervical carcinomas is elevated, and that it can be lowered in some tumors using fractionated radiation therapy. These findings also suggest that IFF values may provide an indication of tumor oxygã