The changes of tumour vascular endothelial growth factor expression after neoadjuvant chemoradiation in patients with rectal adenocarcinoma

. 2017 ; 21 (1) : 48-53. [epub] 20170322

Status PubMed-not-MEDLINE Jazyk angličtina Země Polsko Médium print-electronic

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid28435398

AIM OF THE STUDY: The aim was to examine the effects of neoadjuvant chemoradiotherapy on VEGF expression in patients with locally advanced rectal cancer. MATERIALS AND METHODS: A total of 53 patients with locally advanced rectal cancer were retrospectively studied. Neoadjuvant treatment comprised external beam radiation (50.4 Gy/28 fractions) with continuous infusion of 5-fluorouracil. Four to 6 weeks after the chemoradiotherapy, the patients underwent surgical resection. Immunohistochemistry was performed to assess VEGF expression in the pretreatment biopsies and in resected specimens. RESULTS: Resection with microscopic residual tumour (R1) was performed in two patients while in the remaining 51 patients radical resection with microscopically negative margins (R0) was possible. Downstaging after preoperative chemoradiotherapy was observed in 34 patients (64%). After chemoradiotherapy 24 patients (45%) had decreased VEGF expression, in 20 patients (38%) there was no change, and in two patients it was not possible to assess the dynamics of VEGF expression due to pathologic complete response after chemoradiotherapy. The five-year overall survival (OS) rate was 56% (95% CI: 43-70%). Although the median OS was 2.5 times shorter in patients who experienced decreased VEGF expression during therapy, this difference did not reach statistical significance. VEGF expression was not significant in Cox regression analysis or log-rank test. VEGF expression decreased after neoadjuvant chemoradiotherapy in most patients with rectal adenocarcinoma examined. This decrease was associated with a trend of inferior prognosis. CONCLUSIONS: VEGF expression decreased after neoadjuvant chemoradiotherapy in most patients examined. This decrease was associated with a trend of inferior prognosis.

Zobrazit více v PubMed

Sauer R, Liersch T, Merkel S, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer: results of the German CAO/ARO/AIO-94 randomised phase III trial after a median follow-up of 11 years. J Clin Oncol. 2012;30:1923–33. PubMed

Yaffee P, Osipov A, Tan C, Tuli R, Hendifar A. Review of systemic therapies for locally advanced and metastatic rectal cancer. J Gastrointest Oncol. 2015;6:185–200. PubMed PMC

Nussbaum N, Altomare I. The neoadjuvant treatment of rectal cancer: a review. Curr Oncol Rep. 2015;17:434. doi: 10.1007/s11912-014-0434-9. PubMed DOI

Breen EC. VEGF in biological control. J Cell Biochem. 2007;102:1358–67. PubMed

Kang SM, Maeda K, Onoda N, Chung YS, Nakata B, Nishiguchi Y, Sowa M. Combined analysis of p53 and vascular endothelial growth factor expression in colorectal carcinoma for determination of tumor vascularity and liver metastasis. Int J Cancer. 1997;74:502–07. PubMed

Wong MP, Cheung N, Yuen ST, Leung SY, Chung LP. Vascular endothelial growth factor is up-regulated in the early pre-malignant stage of colorectal tumour progression. Int J Cancer. 1999;81:845–50. PubMed

Zlobec I, Steele R, Compton CC. VEGF as a predictive marker of rectal tumor response to preoperative radiotherapy. Cancer. 2005;104:2517–21. PubMed

Theodoropoulos GE, Lazaris AC, Theodoropoulos VE, Papatheodosiou K, Gazouli M, Bramis J, Patsouris E, Panoussopoulos D. Hypoxia, angiogenesis and apoptosis markers in locally advanced rectal cancer. Int J Colorectal Dis. 2006;21:248–57. PubMed

Glynne-Jones R, Hadaki M, Harrison M. The status of targeted agents in the setting of neoadjuvant radiation therapy in locally advanced rectal cancers. J Gastrointest Oncol. 2013;4:264–84. PubMed PMC

Marquardt F, Rödel F, Capalbo G, Weiss C, Rödel C. Molecular targeted treatment and radiation therapy for rectal cancer. Strahlenther Onkol. 2009;185:371–8. PubMed

Torino F, Sarmiento R, Gasparini G. The contribution of targeted therapy to the neoadjuvant chemoradiation of rectal cancer. Crit Rev Oncol Hematol. 2013;87:283–305. PubMed

Willett CG, Boucher Y, di Tomaso, et al. Direct evidence that the VEGF-specific antibody bevacizumab has antivascular effects in human rectal cancer. Nat Med. 2004;10:145–7. PubMed PMC

Maj E, Papiernik D, Wietrzyk J. Antiangiogenic cancer treatment: The great discovery and greater complexity (Review) Int J Oncol. 2016;49:1773–84. PubMed PMC

Lin Z, Zhang Q, Luo W. Angiogenesis inhibitors as therapeutic agents in cancer: Challenges and future directions. Eur J Pharmacol. 2016;793:76–81. PubMed

Nozue M, Isaka N, Fukao K. Over-expression of vascular endothelial growth factor after preoperative radiation therapy for rectal cancer. Oncol Rep. 2001;8:1247–9. PubMed

Zlobec I, Vuong T, Compton CC, Lugli A, Michel RP, Hayashi S, Jass JR. Combined analysis of VEGF and EGFR predicts complete tumour response in rectal cancer treated with preoperative radiotherapy. Br J Cancer. 2008;98:450–6. PubMed PMC

Dvorak J, Sitorova V, Ryska A, et al. The prognostic significance of changes of tumor epidermal growth factor receptor expression after neoadjuvant chemoradiation in patients with rectal adenocarcinoma. Strahlenther Onkol. 2012;188:833–8. PubMed

Richter I, Dvorak J, Urbanec M, Bluml A, Cermakova E, Bartos J, Petera J. The prognostic significance of tumor epidermal growth factor receptor (EGFR) expression change after neoadjuvant chemoradiation in patients with rectal adenocarcinoma. Contemp Oncol (Pozn) 2015;19:48–53. PubMed PMC

Richter I, Dvorak J, Bluml A, et al. Influence of preoperative chemoradiotherapy on changes of epidermal growth factor receptor expression in patients treated by preoperative chemoradiotherapy for local advanced rectal carcinoma. Klin Onkol. 2014;27:361–6. PubMed

Najít záznam

Citační ukazatele

Pouze přihlášení uživatelé

Možnosti archivace