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Review
Predictive markers of radiotherapy-induced rectal cancer regression
  1. J-S Shin1,2,3,
  2. T-G Tut2,3,
  3. V Ho4,5,
  4. C S Lee1,2,3
  1. 1Department of Anatomical Pathology, Liverpool Hospital, University of Western Sydney, Liverpool BC, New South Wales, Australia
  2. 2Cancer Pathology & Cell Biology Laboratory, Ingham Institute for Applied Medical Research, University of Western Sydney, Liverpool BC, New South Wales, Australia
  3. 3Disciplines of Pathology, University of Western Sydney, Liverpool BC, New South Wales, Australia
  4. 4Department of Gastroenterology, Campbelltown Hospital, University of Western Sydney, Liverpool BC, New South Wales, Australia
  5. 5Department of Medicine, School of Medicine, and Molecular Medicine Research Group, University of Western Sydney, Liverpool BC, New South Wales, Australia
  1. Correspondence to Dr Joo-Shik Shin, Department of Anatomical Pathology, South Western Area Pathology Service, Locked Mail Bag 7090, Liverpool BC, NSW 1871, Australia; j.shin{at}uws.edu.au

Abstract

Patients with locally advanced rectal cancer receive preoperative radiotherapy to reduce the probability of recurrence and to possibly improve overall survival. However, this appears dependent on the extent of histological tumour regression seen in the resected bowel, which can be highly variable between individuals. No predictive marker that can stratify patient management in this regard is currently available. Experimental data implicates a variety of factors that are involved in the DNA damage response following radiation injury, tumour tissue oxygenation, autoimmune antitumour response triggered by radiotherapy and in the pathogenesis of colorectal cancer, as potential indicators of radiation sensitivity. These details are presented in this review, which may serve as targets for clinical validation studies aiming to find predictors of radiotherapy response in rectal cancer.

  • RECTAL CANCER
  • ONCOLOGY
  • GASTROINTESTINAL DISEASE

https://doi.org/10.1136/jclinpath-2014-202494

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