Details

Autor(en) / Beteiligte

• Huang, Eng-Yen, M.D
• Hsu, Hsuan-Chih, M.D
• Sun, Li-Min, M.D., M.P.H
• Chanchien, Chan-Chao, M.D
• Lin, Hao, M.D
• Chen, Hui-Chun, M.D
• Tseng, Chih-Wen, M.D
• Ou, Yu-Che, M.D
• Chang, Hung-Yao, M.D
• Fang, Fu-Min, M.D., Ph.D
• Huang, Yu-Jie, M.D
• Wang, Chang-Yu, M.D., M.S
• Lu, Hsien-Ming, M.D
• Tsai, Ching-Chou, M.D
• Ma, Yen-Ying, M.D
• Fu, Hung-Chun, M.D
• Wang, Yu-Ming, M.D
• Wang, Chong-Jong, M.D

Titel

Prognostic Value of Pretreatment Carcinoembryonic Antigen After Definitive Radiotherapy With or Without Concurrent Chemotherapy for Squamous Cell Carcinoma of the Uterine Cervix

Ist Teil von

• International journal of radiation oncology, biology, physics, 2011-11, Vol.81 (4), p.1105-1113

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2011

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose To evaluate whether pretreatment carcinoembryonic antigen (CEA) levels have a prognostic role in patients after definitive radiotherapy for squamous cell carcinoma (SCC) of the uterine cervix. Methods and Materials A retrospective study of 550 patients was performed. The SCC antigen (SCC-Ag) and CEA levels were regarded as elevated when they were ≥2 and ≥5 ng/mL, respectively. A total of 208 patients underwent concurrent chemoradiotherapy (CCRT). The Kaplan-Meier method was used to calculate the distant metastasis (DM), local failure (LF), disease-free survival (DFS), and overall survival (OS) rates. Multivariate analysis was performed using the Cox proportional hazards model. The hazard ratio (HR) with 95% confidence interval (CI) was evaluated for the risk of a poor prognosis. Results Compared with the patients with normal CEA/SCC-Ag levels, CEA levels ≥10 ng/mL but without elevated SCC-Ag levels was an independent factor for LF (HR, 51.81; 95% CI, 11.51–233.23; p < .001), DM (HR, 6.04; 95% CI, 1.58–23.01; p = .008), DFS (HR, 10.17; 95% CI, 3.18–32.56; p < .001), and OS (HR, 5.75; 95% CI, 1.82–18.18; p = .003) after RT alone. However, no significant role for CEA was noted in patients with SCC-Ag levels ≥2 ng/mL. In patients undergoing CCRT, a CEA level ≥10 ng/mL was an independent factor for LF (HR, 2.50; 95% CI, 1.01–6.21; p = .047), DM (HR, 3.41; 95% CI, 1.56–7.46; p = .002), DFS (HR, 2.73; 95% CI, 1.39–5.36; p = .003), and OS (HR, 3.93; 95% CI 1.99–7.75; p < .001). A SCC-Ag level of ≥40 ng/mL was another prognostic factor for DM, DFS, and OS in patients undergoing not only CCRT, but also RT alone. The 5-year OS rate for CCRT patients with CEA <10 ng/mL and ≥10 ng/mL was 75.3% and 35.8%, respectively ( p < .001). CCRT was an independent factor for better OS (HR, 0.69; 95% CI, 0.50–0.97; p = .034). Conclusion Pretreatment CEA levels in patients with SCC of the uterine cervix provide complementary information for predicting LF, DM, DFS, and OS, except for in patients with abnormal SCC-Ag levels before RT alone. More aggressive therapy might be advisable for patients with CEA levels of ≥10 ng/mL.