Baek, J.Y.

Chi, E.K.

Cho, H.M.

Jang, H.S.

Jeong, B.K.

Jeong, J.U.

Jeong, S.

Kim, D.Y.

Kim, J.H.

Kim, J.S.

Kim, K.

Kim, S.H.

Kim, S.Y.

Kim, T.H.

Lee, J.H.

Nam, T.K.

Oh, J.H.

Shim, B.Y.

Yoon, M.S.

Elsevier - Publisher Connector 

S336                                                                                                                                                    ESTRO 35 2016 
______________________________________________________________________________________________________ 
PO-0717  
Serum miR-345-5p predicts pathological response to 
chemoradiotherapy in local advanced rectal cancer 
J. Yu
1Cancer Hospital- CAMS, Radiation Oncology, Beijing, China 
1, N. Li1, J. Jin1 
 
Purpose or Objective: Neoadjuvant chemoradiation(nCRT) 
has been represented as the standard treatment for locally 
advanced rectal cancer(LARC). Tumor pathological responses 
and radiotherapeutic sensitivity alter variously. We aimed to 
explore the predict value of serum circulating miRNAs, which 
have already been certificated as potential therapeutic 
predictors in many cancers for the pathological responses and 
radiosensitivity after nCRT in LARC patients. 
 
Material and Methods: Six fresh tumor biopsy samples of T3-
4/N+ rectal cancer patients were collected before any 
treatments and these samples were classified as radiation 
sensitive and resistant groups according to the postoperative 
pathological analysis assessed by Mandard TRG scale(3 
samples of TRG1 vs 3 samples of TRG4). The two groups were 
strictly matched by clinical features. miRNAs expression 
profile of the two groups were analyzed by microarray. 
Predictive value of radiotherapeutic sensitivity of the 
candidated miRNAs was further validated by 160 serum 
samples of LARC patients.  
 
Results: 19 miRNAs were identified to have different 
expression profile between radiation sensitive and resistant 
groups by microarray analysis (p<0.05). Among these miRNAs, 
nine miRNAs were down-regulated and ten were up-regulated 
in radiation sensitive group. miR-345-5p was identified 
significantly correlated with radiation resistant to nCRT and 
appeared highly discrepant expression between the two 
groups (fold change>2). Low expression of miR-345-5p in 
serum predicted superior pathological responses to 
radiosensitivity after nCRT (TRG1/2) (AUC=0.69, p<0.001) and 
favorable LRFS (p=0.02). 
 
 
 
Conclusion: Serum level of miR-345-5p is associated with 
favorable pathological responses to neoadjuvant 
chemoradiotherapy and local-regional control ratio in LARC 
patients. It presents as a promising biomarker to predict the 
radiotherapy sensitivity and prognosis. 
 
PO-0718  
The significance of postop CEA after preoperative CRT 
followed by TME in advanced rectal cancer 
S. Jeong
1St. Vincent Hospital- College of Medicine- The Catholic 
University of Korea, radiation oncology, Suwon- Kyeonggi-do, 
Korea Republic of 
1, J.H. Lee1, S.H. Kim1, H.M. Cho2, B.Y. Shim3, D.Y. 
Kim4, T.H. Kim4, S.Y. Kim4, J.Y. Baek4, J.H. Oh4, T.K. Nam5, 
M.S. Yoon5, J.U. Jeong5, K. Kim6, E.K. Chi6, H.S. Jang7, J.S. 
Kim8, J.H. Kim9, B.K. Jeong10 
2St. Vincent Hospital- College of Medicine- The Catholic 
University of Korea, surgery, Suwon- Kyeonggi-do, Korea 
Republic of 
3St. Vincent Hospital- College of Medicine- The Catholic 
University of Korea, internal medicine, Suwon- Kyeonggi-do, 
Korea Republic of 
4Research Institute and Hospital- National Cancer Center, 
Center for Colorectal Cancer, Goyang, Korea Republic of 
5Chonnam National University Hospital, Radiation Oncology, 
Hwasun, Korea Republic of 
6Seoul National University Hospital- College of Medicine, 
Radiation Oncology, Seoul, Korea Republic of 
7Seoul St. Mary`s Hospital- College of Medicine- The Catholic 
University of Korea, Radiation Oncology, Seoul, Korea 
Republic of 
8Seoul National University Bundang Hospital- College of 
Medicine, Radiation Oncology, Bundang, Korea Republic of 
9Dongsan Medical Center- Keimyung University School of 
Medicine, Radiation Oncology, Daegu, Korea Republic of 
10Gyeongsang National University School of Medicine, 
Radiation Oncology, Jinju, Korea Republic of 
 
Purpose or Objective: To evaluate the significance of 
postoperative carcinoembryonic antigen (CEA) level as a 
predictor for tumor recurrence and as a prognostic factor for 
survival in locally advanced rectal cancer patients treated 
with preoperative concurrent chemoradiation followed by 
curative surgery 
 
Material and Methods: Total 1559 rectal cancer patients 
staged with cT3-4N0-2M0 received pelvic preoperative 
chemoradiotherapy (CRT) 50.4 Gy in 28 fractions followed by 
total mesorectal excision (TME). CEA levels were measured 
before CRT and after surgery. Clinicopathologic factors which 
could be associated with tumor recurrence and survival were 
analyzed. 
 
Results: The cumulative probability of the tumor recurrence 
showed a steep increase with a cutoff value of 2.5 ng/mL for 
postoperative CEA, and the gradient decreased as 
postoperative CEA levels increased above 2.5 ng/mL. After 
median follow-up time of 46.7 months, patients with 
postoperative CEA level of > 2.5 ng/mL had significantly 
lower relapse-free survival (75.6% vs. 65.2%, p<0.001) and 
overall survival (88.3% vs. 78.1%, p<0.001) at 5 years than 
patients with CEA level of ≤2.5 ng/mL. In the multivariate 
analysis, postoperative CEA level is the only significant 
prognostic factors of relapse free survival (HR=1.561 and 95% 
CI=1.221-1.996, p<0.001) and overall survival (HR=2.073 and 
95% CI=1.498-2.869, p<0.001). Increased pre-CRT CEA level is 
not a significant prognostic factor with consideration of 
postoperative CEA in multivariate analysis. The postoperative 
CEA level above 2.5 ng/ml is a significant predictor for 
distant recurrence (OR=1.689 and 95% CI=1.188-2.402, 
p=0.004), but not for local recurrence (OR=0.776 and 95% 
CI=0.389-1.549, p=0.472). 
 
Conclusion: Postoperative CEA level above 2.5 ng/ml is a 
predictor for tumor recurrence and a negative prognostic 
factor for survival in rectal cancer patients who received 
preoperative CRT and curative surgery. Physician can 
consider intense surveillance after curative resection in these 
patient. 
 
PO-0719  
Target delineation of anal cancer based on MR or PET – an 
inter-observer, inter-modality study 
E. Rusten
1Oslo University Hospital, Dept of Medical Physics, Oslo, 
Norway 
1,2, B.L. Rekstad1, C. Undseth3, G. Al-Haidari3, B. 
Hanekamp4, E. Hernes5, T.P. Hellebust1, E. Malinen1,2, M. 
Guren3 
2University of Oslo, Biophysics and medical physics, Oslo, 
Norway 
3Oslo University Hospital, Dept of Oncology, Oslo, Norway 


PO-0718: The significance of postop CEA after preoperative CRT followed by TME in advanced rectal cancer 

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PO-0718: The significance of postop CEA after preoperative CRT followed by TME in advanced rectal cancer

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