Innovative treatment strategy for intractable gastroenterological cancer by control of DNA double strand repair pathway

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Patients and Method. 1) One hundred sixty-eight patients with clinical Stage II-III (cStageII-III) ESCC were classified into two groups consisting of 76 who received NACRT followed by esophagectomy and 92 patients who received surgery alone. The prognosis and incidence of postoperative complications were retrospectively compared between the two groups. The pathological response to NACRT as well as the patientprognosis were also analyzed for the NACRT group patients. 2) The expression of Rad51 was investigated in pretreatment biopsy specimens in 41 ESCC cases who underwent surgery after NACRT, and the findings were compared with the pathological response to NACRT. Results. 1) The 5-year survival rate was 47.7% in the surgery alone group and 56.5% in the NACRT group, and the difference was not a statistically 機関番号：17102研究種目：基盤研究（Ｃ）研究期間：2010～2012課題番号：22591457研究課題名（和文） DNA2重鎖切断修復機構の制御による難治性消化器癌に対する革新的治療戦略研究課題名（英文） Innovative treatment strategy for intractable gastroenterological cancer by control of DNA double strand repair pathway研究代表者佐伯 浩司（SAEKI HIROSHI）九州大学・大学病院・助教研究者番号：80325448significant (P=0.4831). However, the 5-year survival rates of patients in whom NACRT was Grade 3 (markedly effective), was obviously better than that of the other patients (Grade0/1 - ineffective/slightly effective: 36.9%, Grade 2 - moderately effective: 53.8%, Grade 3 - markedly effective: 100%). The incidence of postoperative complications was 31.5% in the surgery alone group and 40.8% in the NACRT group, and the difference was not a statistically significant (P=0.2121). 2) Grade 3 was more frequently observed in Rad51-negative cases (n=13) than Rad51-positive cases (n=28; 71.4% vs. 28.6%, P=0.0239). Conclusions. The pathological complete response of NACRT is critical for improving the survival of patients with cStageII-III ESCC. The Rad51 expression in pretreatment biopsy specimens was therefore suggested to be a useful predictive factor for the response to NACRT.