| Guo Yu,Liu Chen,Ren Gang,Kang Xiaoli,Li Ping,Li Jing,Qin Qing,Wang Yingjie,Xia Tingyi.Serum CA19-9 as a predictive value and an effective evaluator for pancreatic cancer patients treated with hypofractionated tomotherapy combined with chemotherapy[J].Chinese Journal of Radiological Medicine and Protection,2018,38(5):344-349 |
| Serum CA19-9 as a predictive value and an effective evaluator for pancreatic cancer patients treated with hypofractionated tomotherapy combined with chemotherapy |
| Received:January 12, 2018 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.05.004 |
| KeyWords:Pancreatic cancer Radiotherapy Serum levels of CA19-9 Prediction Tumor marker |
| FundProject:首都卫生发展科研专项（2014-1-5124） |
| Author Name | Affiliation | E-mail | | Guo Yu | Air Force Clinical College of Anhui Medical University, Beijing 100142, China | | | Liu Chen | Department of Radiotherapy, Air Force General Hospital, Beijing 100142, China | | | Ren Gang | Department of Radiotherapy, Air Force General Hospital, Beijing 100142, China | | | Kang Xiaoli | Department of Radiotherapy, Air Force General Hospital, Beijing 100142, China | | | Li Ping | Department of Radiotherapy, Air Force General Hospital, Beijing 100142, China | | | Li Jing | Department of Radiotherapy, Air Force General Hospital, Beijing 100142, China | | | Qin Qing | Department of Radiotherapy, Air Force General Hospital, Beijing 100142, China | | | Wang Yingjie | Department of Radiotherapy, Air Force General Hospital, Beijing 100142, China | | | Xia Tingyi | Air Force Clinical College of Anhui Medical University, Beijing 100142, China | xiatingyi1959@sina.com |
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| Abstract:: |
| Objective To observe the dynamic changes of serum CA19-9 level before and after the treatment of high-dose and low-fractionated Tomotherapy combined with chemotherapy for pancreatic cancer, and explore the corresponding prognostic, predictive and therapeutic effects. Methods The clinical characteristics and the survival of 75 patients with pancreatic cancer treated in the Department of Radiotherapy of Air Force General Hospital were analyzed retrospectively from December 2012 to June 2017. The effects of baseline CA19-9 and CA19-9 level at 4-6 weeks after the radiotherapy on patient prognosis were analyzed by Kaplan-Meier method and Log-rank test retrospectively. Results The median survival time (MST) was 13.8 months (2.0-58.0 months). The baseline serum CA19-9 was 1 109 U/ml (4.70-70 000 U/ml). The MST in the <1 109 U/ml group and ≥ 1 109 U/ml group were 14.0 months(95% CI:10.04-22.96 months)and 9.0 months(95% CI:7.75-13.25 months)respectively (χ2=6.31, P<0.05). The corresponding median progression-free survival (mPFS) was 7.0 months(95% CI:5.58-8.42 months)and 5.0 months(95% CI:3.81-6.20 months)respectively (χ2=8.51, P<0.05). The median CA19-9 level at 4-6 weeks after radiotherapy was 397.7 U/ml (11.02-43 250 U/ml). A total of 38 cases (38/49, 77.6%) declined, and 11 cases (11/49, 22.4%) increased. The MST of the declined and increased groups were 14.0 months(95% CI:7.24-20.77 months)and 8.0 months(95% CI: 2.69-13.31 months)respectively (χ2=11.19, P<0.05). The corresponding mPFS were 5.5 months(95% CI:4.05-6.95 months)and 4.0 months(95% CI:1.98-6.02 months)respectively (χ2=9.12, P<0.05). The ROC curve determined that the cut-off for the decline of serum CA19-9 was 60.9% at 4 to 6 weeks after radiotherapy.The MST of ≥ 60.9% group and <60.9% group were 33.5 months(95% CI:0.24-66.76 months)and 9.0 months(95% CI:6.92-11.08 months)respectively (χ2=13.80, P<0.05). The corresponding mPFS were 11.0 months(95% CI:3.44-18.56 months)and 5.0 months(95% CI:3.91-6.09 months)respectively (χ2=8.71, P<0.05). Conclusions Patients with the baseline serum CA19-9 <1 109 U/ml had a better outcome after hypofraction tomotherapy combined with chemotherapy. The decline of serum CA19-9 at 4-6 weeks after radiotherapy can serve as a prompt and effective predictor of the outcome and the progression of patients. The decline of serum CA19-9 ≥ 60.9% in patients with pancreatic cancer is associated with a low possibility of disease progression in half a year, whose overall survival is better. |
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