Changes in tumor proliferation of rectal cancer induced by preoperative 5-fluorouracil and irradiation

Christopher G. Willett, Michael Hagan, William Daley, Gretchen Warland, Paul C. Shellito, Carolyn C. Compton

Research output: Contribution to journalArticle

Abstract

PURPOSE: This study examines the effect of 5-fluorouracil administration during preoperative irradiation on rectal cancer tumor proliferation. PATIENTS AND METHODS: One hundred and fifty-three patients with locally advanced rectal cancer received 45 to 50 Gy of preoperative irradiation with (103 patients) and without (50 patients) concurrent 5-fluorouracil, followed by surgery. Pretreatment tumor biopsies and postirradiation surgical specimens were scored for proliferative activity by assaying the extent of Ki-67 and proliferating cell nuclear antigen immunostaining and the number of mitoses per ten high-powered fields. Postirradiation specimens were also assessed for downstaging. RESULTS: Although 5-fluorouracil did not improve downstaging rates, marked decreases in the activity of all three markers of proliferation (mitotic counts, Ki-67, and proliferating cell nuclear antigen immunostaining) were seen in rectal cancers of patients receiving the drug. No significant decreases were noted in patients undergoing irradiation only. CONCLUSION: The addition of 5-fluorouracil to preoperative irradiation resulted in a more complete inactivation of the proliferating population. Frequency of downstaging, however, was unaffected. Thus, the quiescent cell population appears to represent a substantial barrier to further down- staging. New treatment strategies should be aimed at controlled recruitment of quiescent tumor cells at the time of irradiation.

Original languageEnglish (US)
Pages (from-to)62-67
Number of pages6
JournalDiseases of the Colon and Rectum
Volume41
Issue number1
DOIs
StatePublished - Jan 1998
Externally publishedYes

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Rectal Neoplasms
Fluorouracil
Proliferating Cell Nuclear Antigen
Neoplasms
Mitosis
Population
Biopsy
Pharmaceutical Preparations
Therapeutics

Keywords

  • Preoperative irradiation and 5-fluorouracil
  • Proliferating cell nuclear antigen
  • Rectal cancer
  • Tumor proliferation

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Changes in tumor proliferation of rectal cancer induced by preoperative 5-fluorouracil and irradiation. / Willett, Christopher G.; Hagan, Michael; Daley, William; Warland, Gretchen; Shellito, Paul C.; Compton, Carolyn C.

In: Diseases of the Colon and Rectum, Vol. 41, No. 1, 01.1998, p. 62-67.

Research output: Contribution to journalArticle

Willett, Christopher G. ; Hagan, Michael ; Daley, William ; Warland, Gretchen ; Shellito, Paul C. ; Compton, Carolyn C. / Changes in tumor proliferation of rectal cancer induced by preoperative 5-fluorouracil and irradiation. In: Diseases of the Colon and Rectum. 1998 ; Vol. 41, No. 1. pp. 62-67.
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