| Background:Esophageal cancer is a common malignant tumor of the digestive system, it has high morbidity and mortality. The number of patients with esophageal cancer in China accounts for about50percent of the world. Currently, the major treatment to esophageal cancer is Surgery. However, surgical treatment alone can not be always ideal, concurrent chemoradiation has become the routine treatment of esophageal cancer. Meanwhile, there are large individual differences in the sensitivity to chemoradiotherapy, and we still don’t have standard way to predict the sensitivity effectively. So the Selection of clinical treatment may be less accurate.Epidermal growth factor receptor (EGFR) is a tyrosine kinase receptor which expressed by proto-oncogene c-erbB-1(her-1). The cells growth and differentiation may out of control when EGFR overexpression or mutation, leading to excessive proliferation or even canceration. There has been plenty of research which confirmed that the overexpression of EGFR has a significant impact to the sensitivity of chemoradiotherapy in head and neck tumors, non-small cell lung cancer, ovarian cancer, colorectal cancer, etc. Most esophageal squamous cell carcinoma (ESCC) overexpress EGFR, and this may be associated with carcinoma proliferation, invasion, metastasis and blood vessel growth and so on. But the relationship of EGFR with ESCC’s sensitivity to chemoradiotherapy and short-term curative effect is not clear yet. Objective:Patients were detected to divided into two groups, one group overexpressed EGFR while another group did not express it. All the patients underwent concurrent chemoradiation. Then we compared the curative effect of the two groups to study the usefulness of EGFR as applied to predict the sensitivity to chemoradiotherapy in esophageal carcinoma.Methods:1. Tissue samples were collected from35esophageal cancer patients who were treated by center for oncology of provincial hospital affiliated to shandong university during June2007to December2010. Immunohistochemistry was performed for EGFR to divide the tissue samples into two groups.2. Chemoradiotherapy was carried about on all patients. They underwent6MV-X-ray external radiation, radiation dose was2.0Gy/time,5times/week, total doses60-66Gy. Two cycles of chemotherapy (DDP20mg dl-5) were received simultaneously.3.The curative effect and survival time of the two groups were compared, and the sensitivity and prognosis were reviewed against the immunohistochemical staining patterns.Results:1. EGFR expression was observed in74.3%(26/35) tissues and mainly localized in the cytoplasm and membrane, the normal tissues had no expression.2. The complete response (CR) rate of all the patients was45.7%(16/35)3. The CR rate in the EGFR-positive group and EGFR-negative group was57.7%(15/26) and11.1%(1/9), respectively, showing a significant difference(P=0.022).4. Kaplan-Meier survival analysis revealed that there were5patients still alive while30persons had dead, the median survival time (MST) in the EGFR-positive group and EGFR-negative group was14months and20months. It has no significant difference (P=0.192) between them.Conclusion: 1. The majority of ESCC overexpress EGFR and the normal tissues don’t express it, the overexpression of EGFR maybe relate to the tumorigenesis.2. Patients with ESCC have big difference on the sensitivity to chemoradiotherapy, a considerable proportion of patients are not sensitive to the concurrent chemoradiation.3. EGFR expression do not show a significant correlation with the prognosis of patients with ESCC.4. The EGFR-positive group is more sensitive to chemoradiotherapy than EGFR-negative group. EGFR expression level may help to predict the response to chemoradiotherapy in ESCC, although the results should be confirmed in a larger series. |
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