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KMID : 0191120110260040513
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Journal of Korean Medical Science
2011 Volume.26 No. 4 p.513 ~ p.520
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VEGF as a Predictor for Response to Definitive Chemoradiotherapy and COX-2 as a Prognosticator for Survival in Esophageal Squamous Cell Carcinoma
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Yoon Mee-Sun
Nam Taek-Keun
Lee Ji-Shin
Cho Sang-Hee
Song Ju-Young
Ahn Sung-Ja
Chung Ik-Joo
Jeong Jae-Uk
Chung Woong-Ki
Nah Byung-Sik
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Abstract
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We investigated the patterns of pretreatment expression of the epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), and cyclooxygenase-2 (COX-2) by immunohistochemical staining and determined their correlation with treatment response and survival in 44 patients with esophageal squamous cell carcinoma (ESCC) treated with definitive concurrent chemoradiotherapy (CCRT). The definitive CCRT consisted of a median dose of 54 Gy (range: 40.0-68.4 Gy) and two cycles of concurrent administration of mostly 5-fluorouracil + cisplatinum. High expression of EGFR, VEGF, and COX-2 was found in 79.5%, 31.8%, and 38.6%, respectively. The Cox regression analysis for overall survival (OS) showed that both the treatment response and COX-2 expression were significant. The 3-yr OS rates of patients that achieved a complete response and those that did not were 46.7% and 5.3%, respectively (P = 0.006). The logistic regression analysis for treatment response with various parameters showed that only a high expression of VEGF was significantly associated with a complete response. Unlike other well-known studies, higher expression of VEGF was significantly correlated with a complete response to CCRT in this study. However, higher expression of COX-2 was significantly associated with shorter survival. These results suggest that VEGF might be a predictive factor for treatment response and COX-2 a prognostic factor for OS in patients with ESCC after definitive CCRT.
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KEYWORD
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Esophageal Neoplasms, Chemoradiotherapy, Epidermal Growth Factor Receptor, Vascular Endothelial Growth Factor, Cyclooxygenase 2
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