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Neoadjuvant chemoradiotherapy can change the angiogenic factor expressionprofiles of rectal cancer. However, little is known about its possible changes in response topreoperative chemoradiotherapy. We examined the angiogenic factor expressionprofiles of rectal cancer before and after neoadjuvant chemoradiotherapy in patients with rectal carcinoma.Fifty-eight patients with locally advanced rectal cancer were studied. All patients were givenpreoperative chemoradiotherapy of 5040 (please check this figure if possible) cGy for 5-6 weeks with concurrent administration of 5-FU and leucovorin. Surgical resection was performed 6-8 weeks later. Immunohistochemical staining for angiogenenic factors (VEGF, PIGF, HIF 1a, SDF 1a) were performed on specimens obtained beforepreoperative chemoradiotherapy and after surgery. A semiquantitative-immunohistochemical score established from the extension and intensity of the angiogenic factors was used for analysis.Neoadjuvant chemoradiotherapy downregulated VEGFprotein expression in the rectal cancers and led to a lower PlGF, HIF 1aprotein expression in rectal cancer tissues (P < 0.01). However, neoadjuvant chemoradiotherapy upregulated SDF 1aprotein expression in rectal cancer tissues. (P < 0.03). Higher SDF 1aprotein expression after neoadjuvant chemoradiotherapy was significantly associated with advanced TNM stage.Our data suggests that neoadjuvant chemoradiotherapy could up-regulate angiogenic factor SDF 1a, which should be evaluated as a new target for antiangiogenic therapy.