Factors influencing histological response after neoadjuvant chemoradiation therapy for rectal carcinoma
Factors influencing histological response after neoadjuvant chemoradiation therapy for rectal carcinoma
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DOI：
10.1016/j.prp.2009.04.006
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发表时间：
2009-01-01
影响因子：
2.8
通讯作者：
Suarez, Angel
中科院分区：
文献类型：
--
作者：
Moral, Maria;Jesus Fdez-Acenero, Ma;Suarez, Angel
新辅助放化疗是直肠癌的标准治疗方案之一。然而，放化疗治疗并不是完全没有副作用，试图预测哪些患者会对新辅助化疗产生反应是很有趣的。本研究旨在分析影响治疗后病理反应的因素，我们回顾了39例新辅助放化疗患者的临床和形态学资料。我们对石蜡包埋的组织进行了p53、cyclin D1、MIB-1（Ki 67）和bcl-2蛋白的免疫组化检测。在我们的系列中，12例患者对新辅助治疗无反应，12例显示完全反应，15例显示部分反应。反应与心肌病（p = 0 0 2）和里急后重（p = 0 0 2）之间有统计学显著相关性，年龄（p = 0 0 8）、术前TNM（P = 0 0 8）、瘤周炎症反应（p = 0 0 7）和术前CEA（p = 0 0 8）有显著性趋势。在免疫组化方面，我们只发现cyclin D1有显著性趋势（p = 0.08）。在我们的直肠癌术前放化疗患者中，很少有因素能预测其组织学反应。组织学反应似乎可以提高生存率并减少复发。(C)2009年Elsevier GmbH。All rights reserved.
Neoadjuvant chemoradiation therapy is one of the standard therapeutic regimens for rectal carcinoma. Nevertheless, chemoradiation therapy is not completely devoid of adverse effects, and it would be interesting to try to predict which patient will respond to neoadjuvancy This study aimed at analyzing factors influencing pathological response after therapy.We reviewed the clinical and morphological data of 39 patients after neoadjuvant chemoradiation therapy. We performed immunohistochemistry for p53, cyclin D1, MIB-1 (Ki67), and bcl-2 protein in paraffin-embedded tissue.In our series, 12 patients did not respond to neoadjuvant therapy, 12 showed it complete response, and 15 it partial response. There was it statistically significant association between response and cardiomyopathy (p = 0 02) and tenesmus (p = 0.02) and a trend towards significance for age (p = 0 08), preoperative TNM (P = 0.08), peritumoral inflammatory response (p = 0.07), and preoperative CEA (p = 0 08). As for immunohistochemistry, we only found it trend towards significance for cyclin D1 (p = 0 08).In our series of patients with rectal carcinoma receiving preoperative chemoradiation therapy, few factors were predictive of it histological response. The histological response seems to improve survival and reduce relapses. (C) 2009 Elsevier GmbH. All rights reserved.