The role of COX-2 in rectal cancer treated with preoperative radiotherapy

Authors: Bouzourene, Hanifa1; Yan, Pu2; Sandmeier, Dominique2; Zouhair, Abderrahim3; Matter, Maurice4; Vuilleumier, Henri4; Coucke, Philippe5

Source: Virchows Archiv, Volume 452, Number 5, May 2008 , pp. 499-505(7)

Publisher: Springer

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Abstract:

Radiotherapy is one of the principal modalities of rectal cancer treatment, and the ability to predict radio resistance could potentially improve survival through a targeted treatment approach. Cyclooxygenase-2 (COX-2) may protect against damage by irradiation that would justify the use of COX-2 inhibitors. The purpose of this study was to investigate the potential role of COX-2 in tumor response and outcome of patients with rectal cancer treated preoperatively with radiotherapy. Using immunohistochemistry, we examined COX-2 expression in 88 surgical specimens of rectal cancer treated preoperatively and in 26 pretherapeutic biopsies. We tested whether COX-2 expression was correlated with clinico-pathologic parameters and with survival and local recurrence. COX-2 was expressed in 50% of the pretherapeutic tumor biopsies and in 88.6% of post-irradiated surgical samples. COX-2 expression was correlated only with enhanced tumor inflammation (p = 0.03) and with tumor volume exceeding 30 cc (p = 0.05). COX-2 was not significantly correlated with patient survival, but none of the patients with COX-2 negative tumors did recur locally, whereas 80% of patients with local recurrences have COX-2 positive tumors. We conclude that COX-2 expression is overexpressed in the majority of rectal cancers treated with radiotherapy and likely plays a role in local relapse.

Keywords: Radiotherapy; Rectal cancer; Cyclooxygenase-2; Survival; Recurrence

Document Type: Research article

DOI: 10.1007/s00428-008-0606-9

Affiliations: 1: Institute of Pathology, Centre Hospitalier Universitaire Vaudois, Bugnon 25, CH 1011, Lausanne, Switzerland, Email: Hanifa.Bouzourene@chuv.ch 2: Institute of Pathology, Centre Hospitalier Universitaire Vaudois, Bugnon 25, CH 1011, Lausanne, Switzerland 3: Department of Radiooncology, Centre Hospitalier Universitaire Vaudois, CH 1011, Lausanne, Switzerland 4: Department of Surgery, Centre Hospitalier Universitaire Vaudois, CH 1011, Lausanne, Switzerland 5: Department of Radiation-Oncology, Hôpital Maisonneuve-Rosemont, 5415, Boulevard de l'Assomption, Montréal, QC, Canada, H1T 2M4

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