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J Korean Soc Ther Radiol Oncol > Volume 25(4); 2007 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2007;25(4): 193-200.
MDM2, p53 and pRb Expression Prior to Definitive Chemoradiotherapy in Esophageal Carcinoma
Mee Sun Yoon, Taek Keun Nam, Jae Hyuk Lee, Sang Hee Cho, Ju Young Song, Sung Ja Ahn, Ik Joo Chung, Woong Ki Chung, Byung Sik Nah
1Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea. thnam@chonnam.ac.kr
2Department of Pathology, Chonnam National University Medical School, Gwangju, Korea.
3Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
This study evaluated the pretreatment expression patterns of MDM2, p53, and pRb proteins to determine if the expression patterns could predict the outcome of concurrent chemoradiotherapy (CCRT) for esophageal squamous cell carcinoma and aid in the decisions for the selection of treatment modalities.
Fifty-one patients that were treated with definitive chemoradiotherapy for stage I~IVa esophageal squamous cell carcinoma were selected for this study. Radiotherapy was administered with daily 1.8~2 Gy fractions up to a median dose of 54 Gy for primary tumors, and with four cycles of cisplatin/5- fluorouracil chemotherapy that was administered every 4 weeks, the first two cycles of which were administered concurrently with radiotherapy. Expression of MDM2, p53, and pRb was investigated by immunohistochemical analysis using pretreatment biopsy specimens.
MDM2, p53, and pRb were detected with high immunoreactivity in 19.6%, 27.5%, and 66.7% of the patients, respectively. However, there was no significant correlation between expression of these factors and clinical outcome. By the use of multivariate analysis with nine covariates-age, tumor location, tumor length, stage, pathological response, clinical response, MDM2 expression, p53 expression, and pRb expression, only pathological response and stage were significant factors for cause-specific survival.
Expression of MDM2, p53, and pRb was not found to be clinically significant for predicting outcomes after CCRT in this study. Further studies with a larger patient population and longer follow-up periods are needed to re-evaluate the expression pattern and to identify new predictors for CCRT response.
Key Words: Esophageal neoplasms, Chemoradiotherapy, MDM2, p53, pRb, Immunohistochemistry
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