Epidermal growth factor receptor as a predictor of tumor downstaging in locally advanced rectal cancer patients treated with preoperative chemoradiotherapy
- Department of Radiation Oncology, Chungnam National University College of Medicine, Daejeon (Korea, Republic of) and Cancer Research Institute, Chungnam National University, Daejeon (Korea, Republic of)
- Cancer Research Institute, Chungnam National University, Daejeon (Korea, Republic of)
- Department of Pathology, Chungnam National University College of Medicine, Daejeon (Korea, Republic of)
- Department of Radiation Oncology, Chungnam National University College of Medicine, Daejeon (Korea, Republic of)
Purpose: To examine retrospectively whether levels of epidermal growth factor receptor (EGFR) expression can predict tumor downstaging after preoperative chemoradiotherapy in patients with locally advanced rectal cancer. Methods and Materials: A total of 183 patients with rectal cancer (cT3-T4 or N+) were enrolled in this study. Preoperative chemoradiotherapy consisted of 50.4 Gy of pelvic radiation with concurrent 5-fluorouracil and leucovorin bolus intravenous chemotherapy in 94 patients or oral capecitabine and leucovorin in 89 patients. EGFR expression in pretreatment paraffin-embedded tumor biopsy specimens was assessed by immunohistochemistry. EGFR expression was determined from the intensity and extent of staining. Tumor downstaging was defined as a reduction of at least one T-stage level. Results: Tumor downstaging occurred in 97 patients (53%), and the tumors showed a pathologic complete response in 27 patients (15%). Positive EGFR expression was observed in 140 (76%) of 183 patients. EGFR expression levels were low in 113 patients (62%) and high in 70 patients (38%). On logistic regression analysis, the significant predictive factor for increased tumor downstaging was a low level of EGFR expression and preoperative chemotherapy using oral capecitabine (odds ratio, 0.437; p 0.012 vs. odds ratio, 3.235; p < 0.001, respectively). Conclusion: A high level of EGFR expression may be a significant predictive molecular marker for decreased tumor downstaging after preoperative chemoradiotherapy in locally advanced rectal cancer.
- OSTI ID:
- 20850069
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 66, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2006.04.026; PII: S0360-3016(06)00661-4; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
Similar Records
Association between pathologic response in metastatic lymph nodes after preoperative chemoradiotherapy and risk of distant metastases in rectal cancer: An analysis of outcomes in a randomized trial
Randomized, Multicenter, Phase IIB Study of Preoperative Chemoradiotherapy in T3 Mid-Distal Rectal Cancer: Raltitrexed + Oxaliplatin + Radiotherapy Versus Cisplatin + 5-Fluorouracil + Radiotherapy