title: [Prognostic significance of changes of tumor epidermal growth factor receptor expression after neoadjuvant chemoradiation in patients with rectal adenocarcinoma].
abstract: OBJECTIVE
  The aim of the present study was to examine the effect of neoadjuvant chemoradiation on tumor epidermal growth factor receptor (EGFR) expression in patients with locally advanced rectal adenocarcinoma.
  
  
  METHODS
  A total of 53 patients with rectal adenocarcinoma (clinical stages II and III) were studied. Neoadjuvant treatment consisted of 50.4 Gy/28 fractions external radiation with concomitant continuous 5-fluorouracil. Surgical resection was performed 4-6 weeks after the chemoradiation. EGFR expression in the pretreatment biopsies and in the resected specimens was assessed with immunohistochemistry.
  
  
  RESULTS
  Patients with an increase of EGFR expression during chemoradiation had significantly shorter disease-free survival (DFS; p = 0.003) and overall survival (OS; p = 0.005) compared to patients with either no change or decrease in EGFR expression. The 5-year DFS in patients with increased EGFR expression was only 29% compared to 61% in patients without an increase of EGFR expression. Similarly, the 5-year OS of the patients with increased EGFR expression was 29% compared to 66% in patients without an increase of EGFR expression. All recurrences in patients who had an increase of EGFR expression occurred within the first 2 years after the treatment. The increase in EGFR expression was the only significant predictor of DFS (p = 0.007) and OS (p = 0.04) using multivariate Cox regression analysis.
  
  
  CONCLUSIONS
  An increase of EGFR expression during chemoradiation may be associated with significantly shorter DFS and OS. The increase of EGFR could identify a population of patients in whom the effect of the treatment with anti-EGFR therapy should be studied.
authors: Department of Oncology and Radiotherapy, Charles University Medical School and Teaching Hospital, Hradec Kralove, Czech Republic. dvorakj@fnhk.cz
authors: J
authors: J
authors: Dvorak
authors: V
authors: V
authors: Sitorova
authors: A
authors: A
authors: Ryska
authors: I
authors: I
authors: Sirak
authors: I
authors: I
authors: Richter
authors: J
authors: J
authors: Hatlova
authors: A
authors: A
authors: Ferko
authors: B
authors: B
authors: Melichar
authors: J
authors: J
authors: Petera
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism* / Q000628:therapy*; D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism*; D059186:Chemoradiotherapy, Adjuvant; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009363:Neoplasm Proteins / Q000378:metabolism; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000628:therapy*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D066246:ErbB Receptors