Sensitivity study on preoperative individual concomitant radiochemotherapy for rectal cancer
10.3760/cma.j.issn.1671-0274.2014.06.011
- VernacularTitle:直肠癌术前个体化同步放化疗敏感性研究
- Author:
Haiping PEI
1
;
Qian PEI
;
Shaobin WU
;
Hong ZHU
Author Information
1. 中南大学湘雅医院胃肠外科
- Keywords:
Rectal neoplasms;
Preoperational concomitant radiochemotherapy;
Epidemical growth factor receptor;
Individualized therapy
- From:
Chinese Journal of Gastrointestinal Surgery
2014;(6):565-569
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictive factors of sensitivity to preoperative concomitant radiochemotherapy for the local mid-low advanced rectal cancer in order to guide the individualized therapy. Methods Clinicopathologic data of 44 patients with local mid-low advanced rectal cancer receiving preoperational concomitant radiochemotherapy were retrospectively analyzed. Expression of epidemical growth factor receptor (EGFR) in biopsy specimen was detected with SP immunohistochemisty (IHC). Downstaging of tumor TNM stage and tumor regression grade (TRG) after radiochemotherapy were used as the standards of sensitivity to preoperational concomitant radiochemotherapy. Association of EGFR expression and pathological change with clinicopathological data before radiochemotherapy (gender, age, pathological type, tumor TNM stage, serum CEA, CA199, radiation method, etc) was analyzed. Results Percentage of downstaging of tumor TNM stage and 3-4 TRG in patients with negative or weak positive EGFR expression was significantly higher as compared to those with strong and moderate positive EGFR expression [86.7%(13/15) vs. 30.4%(7/23), P<0.01; 80.0%(12/15) vs. 8.7%(2/23), P<0.01]. Percentage of downstaging of tumor TNM stage and 3-4 TRG in patients with tubular adenocarcinoma was significantly higher as compared to those with mucous adenocarcinoma [61.8%(21/34) vs. 10.0%(1/10), P<0.01; 47.1 (16/34) vs. 0 (0/10), P<0.01]. EGFR expression was not associated with pathological type (P>0.05). Sensitivity to preoperative concomitant radiochemotherapy was not associated with age, gender, tumor stage, tumor differentiation, serum CEA, serum CA199 and radiation method (all P>0.05). Conclusions Pathological type and EGFR expression level may be two independent predictive markers of sensitivity to preoperative concomitant radiochemotherapy for patients with rectal cancer. Patients with tubular adenocarcinoma or low EGFR expression in tumor tissue may be more sensitive to concomitant radiochemotherapy.
