Tumor Markers of Neo-Adjuvant Chemo-Radiation Response in Rectal Cancer

摘要: Radiation therapy alone or in combination with chemotherapy has lead to improved outcomes the management of rectal cancer patients. Many studies have demonstrated that for locally advanced cancer, preoperative chemoradiation (CRT) significantly improves local control, reduces toxicity profiles and risk disease recurrence (HabrGama, Perez et al. 2004), (Kapiteijn, Marijnen 2001), (Frileux, Burdy 2007), (Horisberger, Hofheinz 2008), (Krook, Moertel 1991), (Sauer, Becker 2004). Highly radiosensitive cancers completely regress, leading survival. A histology tumor grading system is used determine success radiation prior surgery. This called a regression grade (TRG). Originally described oesophageal tumors, TRG been adapted (Mandard, Dalibard 1994). Regression stratifies response based on biological effect dividing it into five different grades ratio fibrosis where TRG1: no residual cancer; TRG2: rare cells; TRG3 outgrowing TRG4: 5: absence regressive changes. scoring extremely valuable as can highlight those tumors demonstrating large variation not undergoing T stage change (Bouzourene, Bosman 2002). In paper by Ryan al, they revised 5 point 3 1 indicates complete response, 2 partial (Ryan, Gibbons 2005). Currently, only approximately 25% patients who receive CRT treatment obtain pathological (Valentini, Coco 2002; Sauer, Disease free survival these reduce rate However, up 75% achieves little benefit an increased second documented within adjacent irradiated volume (Birgisson, Pahlman The broad unpredictable treated chemoradiotherapeutic interventions shows our understanding molecular events radioresistance affected this malignancy limited. thought depend size but also properties individual tumors. It important understand what factors predict high sensitivity new-adjuvant regimen determines resistance, information may allow tailor-made individualization therapy. Classification