The Prognostic Significance of the Expression Change of EGFR during Neoadjuvant Chemoradiotherapy in Patients with Rectal Carcinoma

Abstract

Aim of the study: the aim of this retrospective study was to determine the prognostic impact of epidermal growth factor receptor (EGFR) expression changes during neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer.Material and methods: fifty patients with locally advanced rectal cancer were evaluated. All the patients were administered the total dose of 44 Gy. Capecitabine was concomitantly administered in the dose 825 mg/m 2 in two daily oral administrations. Surgery was indicated 4-8 weeks from the chemoradiotherapy completion. EGFR expression in the pretreatment biopsies and in the resected specimens was assessed with immunohistochemistry.Results: all 50 patients received radiotherapy without interruption up to the total planned dose. The median disease-free survival was 64.9 months, and median overall survival was 76.4 months. Increased EGFR expression was found in 12 patients (26.1%). A statistically significant shorter overall survival (p < 0.0001) and disease-free survival (p < 0.0001) were found in patients with increased expression of EGFR compared with patients where no increase in the expression of EGFR during neoadjuvant chemoradiotherapy was observed.Conclusions: the overexpression of EGFR during neoadjuvant chemoradiotherapy for locally advanced rectal adenocarcinoma is associated with significant shorter overall survival and disease-free survival.