A histopathological assessment of the response of rectal adenocarcinoma to combination chemo-radiotherapy: relationship to apoptotic activity, p53 and bcl-2 expression

Eur J Surg Oncol. 1998 Jun;24(3):169-73. doi: 10.1016/s0748-7983(98)92861-x.


Aims: To investigate the use of pre-operative chemo-irradiation in downstaging advanced rectal cancer prior to surgical resection.

Methods: We examined the pathological effects of chemo-irradiation on 24 rectal tumours and correlated the efficacy of treatment with the level of apoptosis, mitosis, P53 and bcl-2 protein expression on pre-treatment biopsies.

Results: All tumours were resectable following chemo-irradiation. Six cancers showed complete regression with no viable tumour in the resection specimen. A significant correlation was found between spontaneous tumour apoptosis and tumour regression.

Conclusions: Our results suggest that in rectal cancer the apoptotic rate in untreated tumour tissue may predict sensitivity to radiation and cytotoxic agents. No relationship was found between regression and mitotic rate, p53 or bcl-2 expression.

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / physiopathology
  • Adenocarcinoma / radiotherapy
  • Adenocarcinoma / therapy*
  • Apoptosis / drug effects*
  • Apoptosis / radiation effects*
  • Chemotherapy, Adjuvant
  • Gene Expression Regulation, Neoplastic / drug effects*
  • Gene Expression Regulation, Neoplastic / radiation effects*
  • Humans
  • Mitotic Index / drug effects
  • Mitotic Index / radiation effects
  • Proto-Oncogene Proteins c-bcl-2 / metabolism*
  • Radiotherapy, Adjuvant
  • Rectal Neoplasms / drug therapy
  • Rectal Neoplasms / pathology*
  • Rectal Neoplasms / physiopathology
  • Rectal Neoplasms / radiotherapy
  • Rectal Neoplasms / therapy*
  • Tumor Suppressor Protein p53 / metabolism*


  • Proto-Oncogene Proteins c-bcl-2
  • Tumor Suppressor Protein p53