Angiogenic Factor Expression During Fractionated Irradiation

Pilot Study to Determine the Effect of Fractionated Radiotherapy on Expression of Pro-angiogenic Factors in Oesophagus Carcinoma

The main question of this study is if and when VEGF (vascular endothelial growth factor) expression in the tumor is upregulated during chemoradiation and if bevacizumab inhibits subsequent vessel growth in the tumor.

• Therefore the first aim of this study is to identify the time point of induction of VEGF in the tumor tissue of esophagus carcinoma during chemoradiation (after 1,2,3 or 4 weeks of chemoradiation).
• If we identify increased expression of VEGF at a certain time point, our second aim is to determine if we can inhibit the subsequent tumor vessel growth by administration of bevacizumab.

Inclusion Criteria:

• patients that will receive chemoradiation following CROSS-schedule before surgery for esophageal carcinoma
• ability to give informed consent
• age 18 years or older

Exclusion Criteria:

• pregnancy
• evidence of bleeding diathesis, coagulopathy
• inflammation of the GI-tract
• brain metastases
• diastolic/ systolic hypertension, not responding to treatment
• arterial thromboembolism in medical history
• surgery within the month prior to start of bevacizumab treatment