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Bromodeoxyuridine Labeling Index as an Indicator of Early Tumor Response to Preoperative Radiotherapy in Patients with Rectal Cancer

  • Published:
Journal of Gastrointestinal Surgery

Abstract

Purpose

Assessment of tumor proliferation rate using Bromodeoxyuridine labeling index (BrdUrdLI) as a possible predictor of rectal cancer response to preoperative radiotherapy (RT).

Methods and material

Ninety-two patients were qualified either to short RT (5 Gy/fraction/5 days) and surgery about 1 week after RT (schedule I), or to short RT and 4–5 weeks interval before surgery (schedule II). Tumor samples were taken twice from each patient: before RT and at the time of surgery. The samples were incubated with BrdUrd for 1 h at 37°C, and the BrdUrdLI was calculated as a percentage of BrdUrd-labeled cells.

Results

Thirty-eight patients were treated according to schedule I and 54 patients according to schedule II. Mean BrdUrdLI before RT was 8.5% and its value did not differ between the patients in the two compared groups. After RT tumors showed statistically significant growth inhibition (reduction of BrdUrdLI). As the pretreatment BrdUrd LI was not predictive for early clinical and pathologic tumor response, prognostic role of the ratio of BrdUrdLI after to BrdUrdLI before RT was considered. The ratios were calculated separately for fast (BrdUrd LI > 8.5%) and slowly (BrdUrd LI ≤ 8.5%) proliferating tumors and correlated with overall treatment time (OTT, i.e., time from the first day of RT to surgery). One month after RT, accelerated proliferation was observed only in slowly proliferating tumors.

Conclusions

Pretreatment BrdUrdLI was not predictive for early clinical and pathologic tumor response. The ratio after/before RT BrdUrdLI was correlated to inhibition of proliferation in responsive tumors.

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Acknowledgments

The authors would like to thank Anna Cichocka, M.Sc. for her valuable assistance. This work was supported by a grant of the State Committee for Scientific Research No. PBZ-KBN-091/P05/2003.

Conflicts of Interest

None.

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Authors and Affiliations

  1. Department of Applied Radiobiology, Center of Oncology, Garncarska 11, 31-115, Krakow, Poland

    Anna Gasinska, Joanna Niemiec, Beata Biesaga & Agnieszka Adamczyk

  2. Department of Gastrointestinal and Urological Cancer Unit, Center of Oncology, Krakow, Poland

    Jan Skolyszewski & Teresa Kowalska

  3. Collegium Medicum, Jagiellonian University, Kopernika 40, Krakow, Poland

    Tadeusz Popiela, Piotr Richter & Krzysztof Bucki

  4. Department of Surgery, Center of Oncology, Krakow, Poland

    Zbigniew Darasz

  5. Department of Pathophysiology, Collegium Medicum, Jagiellonian University, Krakow, Poland

    Krystyna Nowak

  6. Breast and Thoracic Cancer Unit, Center of Oncology, Krakow, Poland

    Krzysztof Malecki

  7. Department of Radiation Oncology, Center of Oncology, Krakow, Poland

    Marian Reinfuss

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  1. Anna Gasinska
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  2. Jan Skolyszewski
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Correspondence to Anna Gasinska.

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Gasinska, A., Skolyszewski, J., Popiela, T. et al. Bromodeoxyuridine Labeling Index as an Indicator of Early Tumor Response to Preoperative Radiotherapy in Patients with Rectal Cancer. J Gastrointest Surg 11, 520–528 (2007). https://doi.org/10.1007/s11605-007-0127-x

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  • DOI: https://doi.org/10.1007/s11605-007-0127-x

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