A histopathological assessment of the response of rectal adenocarcinoma to combination chemo-radiotherapy: relationship to apoptotic activity, p53 and bcl-2 expression

• Published in: European journal of surgical oncology Vol. 24; no. 3; pp. 169 - 173
• Main Authors: Scott, N., Hale, A., Deakin, M., Hand, P., Adab, F.A., Hall, C., Williams, G.T., Elder, J.B.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Ltd 01.06.1998; Elsevier
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - pathology; Adenocarcinoma - physiopathology; Adenocarcinoma - radiotherapy; Adenocarcinoma - therapy; apoptosis; Apoptosis - drug effects; Apoptosis - radiation effects; Biological and medical sciences; Chemotherapy, Adjuvant; Gastroenterology. Liver. Pancreas. Abdomen; Gene Expression Regulation, Neoplastic - drug effects; Gene Expression Regulation, Neoplastic - radiation effects; Humans; Medical sciences; Mitotic Index - drug effects; Mitotic Index - radiation effects; protein p53; Proto-Oncogene Proteins c-bcl-2 - metabolism; radiotherapy; Radiotherapy, Adjuvant; rectal neoplasm; Rectal Neoplasms - drug therapy; Rectal Neoplasms - pathology; Rectal Neoplasms - physiopathology; Rectal Neoplasms - radiotherapy; Rectal Neoplasms - therapy; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumor Suppressor Protein p53 - metabolism; Tumors; radiotherapy; apoptosis; protein p53; rectal neoplasm; Human; Rectal disease; Treatment efficiency; Stage classification; Adjuvant treatment; Malignant tumor; Gene expression; Radiotherapy; Pathology; TP53 Gene; Rectum; Digestive diseases; Intestinal disease; Preoperative; Apoptosis
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/S0748-7983(98)92861-X

To investigate the use of pre-operative chemo-irradiation in downstaging advanced rectal cancer prior to surgical resection. We examined the pathological effects of chemo-irradiation on 24 rectal tumours and correlated the efficacy of treatment with the level of apoptosis, mitosis, p53 and bcl-2 protein expression in pre-treatment biopsies. All tumours were resectable following chemo-irradiation. Six cancers showed complete regression with no viable tumour in the resection specimen. A significant correlation was found between spontaneous tumour apoptosis and tumour regression. Our results suggest that in rectal cancer the apoptotic rate in untreated tumour tissue may predict sensitivity to radiation and cytotoxic agents. No relationship was found between regression and mitotic rate, p53 or bcl-2 expression.