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High intrinsic apoptosis, but not radiation-induced apoptosis, predicts better survival in rectal carcinoma patients
- Source :
- International Journal of Radiation Oncology, Biology, Physics, 57, 2, pp. 434-43, International Journal of Radiation Oncology, Biology, Physics, 57, 434-43
- Publication Year :
- 2003
-
Abstract
- Contains fulltext : 142643.pdf (Publisher’s version ) (Closed access) PURPOSE: An important feature of malignant tumors is the disturbance in the balance between proliferation and cell death. We evaluated the relevance of intrinsic and radiation-induced apoptosis and proliferation for prognosis in rectal cancer patients. METHODS AND MATERIALS: Patients were selected from a study that randomized for preoperative radiotherapy (RT). Apoptosis and proliferation were scored using specific antibodies in immunohistochemistry. The number of positive cells per square millimeter of carcinoma cells was determined in 98 randomly selected tumors, of which 45 had been irradiated. For the survival analyses, a cohort of 104 patients without positive circumferential resection margins was selected. RESULTS: In nonirradiated patients, high levels of intrinsic apoptosis correlated with better local control (p = 0.04) and better cancer-specific survival (p = 0.02). RT increased the median amount of apoptosis from 10.8 to 21.5 cells/mm(2) (p = 0.004), but this was not predictive for survival. The amount of proliferative cells was not altered after RT and had no influence on prognosis. CONCLUSIONS: Intrinsic apoptosis correlated with both local control and cancer-specific survival, but proliferation was not predictive for prognosis. However, although RT increased apoptosis, its prognostic value was lost after RT. This is possibly because in rectal cancer, the proliferative status of tumors is always high and the aggressiveness of the tumor is determined by the number of "spontaneous" apoptotic tumor cells.
- Subjects :
- Male
Oncology
Cancer Research
medicine.medical_specialty
Programmed cell death
Cell division
Colorectal cancer
medicine.medical_treatment
Apoptosis
Internal medicine
medicine
Carcinoma
Humans
Radiology, Nuclear Medicine and imaging
Neoplasm Staging
Randomized Controlled Trials as Topic
Radiation
Rectal Neoplasms
business.industry
Intrinsic apoptosis
Middle Aged
Prognosis
medicine.disease
Tumor microenvironment [UMCN 1.3]
Radiation therapy
Ki-67 Antigen
Immunohistochemistry
Female
Neoplasm Recurrence, Local
business
Cell Division
Subjects
Details
- ISSN :
- 03603016
- Volume :
- 57
- Database :
- OpenAIRE
- Journal :
- International Journal of Radiation Oncology, Biology, Physics
- Accession number :
- edsair.doi.dedup.....d346214cf1a05b595e55d8f329027fc6