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Potential Role of Single Nucleotide Polymorphisms of XRCC1, XRCC3, and RAD51 in Predicting Acute Toxicity in Rectal Cancer Patients Treated With Preoperative Radiochemotherapy

Osti, Mattia F. MD*; Nicosia, Luca MD*; Agolli, Linda MD*; Gentile, Giovanna PhD; Falco, Teresa MD*; Bracci, Stefano MD*; Di Nardo, Francesco MD; Minniti, Giuseppe PhD*; De Sanctis, Vitaliana MD*; Valeriani, Maurizio MD*; Maglio, Marianna MD*; Borro, Marina PhD; Simmaco, Maurizio PhD; Enrici, Riccardo M. MD*

American Journal of Clinical Oncology: December 2017 - Volume 40 - Issue 6 - p 535–542
doi: 10.1097/COC.0000000000000182
Original Articles: Gastrointestinal

Objectives: To investigate the association between polymorphisms of DNA repair genes and xenobiotic with acute adverse effects in locally advanced rectal cancer patients treated with neoadjuvant radiochemotherapy.

Methods: Sixty-seven patients were analyzed for the current study. Genotypes in DNA repair genes XRCC1 (G28152A), XRCC3 (A4541G), XRCC3 (C18067T), RAD51 (G315C), and GSTP1 (A313G) were determined by pyrosequencing technology.

Results: The observed grade ≥3 acute toxicity rates were 23.8%. Chemotherapy and radiotherapy were interrupted for 46 and 14 days, respectively, due to critical complications. Four patients were hospitalized, 6 patients had been admitted to the ER, and 5 patients received invasive procedures (2 bladder catheters, 2 blood transfusions, and 1 growth factor therapy).

RAD51 correlated with acute severe gastrointestinal toxicity in heterozygosity (Aa) and homozygosity (AA) (P=0.036). Grade ≥3 abdominal/pelvis pain toxicity was higher in the Aa group (P=0.017) and in the Aa+AA group (P=0.027) compared with homozygous (aa) patients. Acute skin toxicity of any grade occurred in 55.6% of the mutated patients versus 22.8% in the wild-type group (P=0.04) for RAD51. XRCC1 correlated with skin toxicity of any grade in the Aa+AA group (P=0.03) and in the Aa group alone (P=0.044). Grade ≥3 urinary frequency/urgency was significantly higher in patients with AA (P=0.01), Aa (P=0.022), and Aa+AA (P=0.031) for XRCC3 compared with aa group.

Conclusions: Our study suggested that RAD51, XRCC1, and XRCC3 polymorphisms may be predictive factors for radiation-induced acute toxicity in rectal cancer patients treated with preoperative combined therapy.

*Institute of Radiation Oncology

Department of Advanced Molecular Diagnostic, Sapienza University

Department of Public Health, Catholic University of Sacred Heart, Rome, Italy

The authors declare no conflicts of interest.

Reprints: Luca Nicosia, MD, Radiation Oncology, Sant’Andrea Hospital, Via di Grottarossa 1035-1039-00189, Rome, Italy. E-mail:

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.