At the individual level however, there can be significant variation in the degree of initial tumour response to radiotherapy. In this context, the TRG score provides an indicator of the regressive response of a tumor to cytotoxic treatment such as radiotherapy. The AJCC Staging Manual (7th ed.) recommends consideration of the TRG independent of the TNM system. The TRG provides important prognostic information because complete or subtotal tumor regression is widely recognized to be associated with better patient outcomes . Unfortunately, the majority of patients show no response or only a partial response to neoadjuvant therapy. For example, none of the patients in our study showed a complete TRG response; 82.4% showed a poor response and 17.6% showed a minimal to moderate response. However, a meta-analysis performed by Lee et al indicated that even partial tumor regression after preoperative chemoradiotherapy improves DFS, and should be considered as a favorable prognostic factor .