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Early diagnosis of radiotherapy failure for patients with head and neck cancer: the role of biochemical markers. TUMORI JOURNAL 2018; 104:273-279. [PMID: 28604997 DOI: 10.5301/tj.5000639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE There is a lack of effective diagnostic tools for early assessment of radiotherapy (RT) outcome in patients with head and neck cancer (HNC). The timely diagnosis of treatment failure may facilitate use of salvage procedures to prevent disease progression. We assessed squamous cell carcinoma antigen and CYFRA 21-1 as early markers of radiotherapy failure in patients with HNC. METHODS Between January 2009 and February 2012, 185 patients (median age 59 years) with squamous cell carcinoma were treated with curative intent with RT alone or combined with chemotherapy (ChT). Markers were estimated in the serum 2 times: before RT and after completion of treatment. RESULTS The median of follow-up was 40 months. Locoregional control (LRC) was 53% and locoregional failure (LRF) was 31%. When comparing LRC and LRF, there were no significant differences between markers concentration obtained before RT. After RT, CYFRA 21-1 (p = 0.018) was significantly elevated in the LRF group. Patients with CYFRA 21-1 <1.79 ng/mL had a higher disease-free survival rate compared to patients with CYFRA 21-1 ≥1.79 ng/mL (74% vs 53%, respectively). After RT, CYFRA 21-1 was significantly related to the overall survival ratio in both univariate (p = 0.049) and multivariate analysis (p = 0.019). CONCLUSIONS CYFRA 21-1 assessed at the end of RT or ChT seems to be a prognostic marker for tumor response. A high concentration of CYFRA 21-1 after treatment increases the risk of death. CYFRA 21-1 might be suggested in the monitoring of carcinomas of HNC.
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Chen HH, Wang HM, Fan KH, Lin CY, Yen TC, Liao CT, Chen IH, Kang CJ, Huang SF. Pre-treatment levels of C-reactive protein and squamous cell carcinoma antigen for predicting the aggressiveness of pharyngolaryngeal carcinoma. PLoS One 2013; 8:e55327. [PMID: 23383155 PMCID: PMC3561298 DOI: 10.1371/journal.pone.0055327] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 12/21/2012] [Indexed: 11/18/2022] Open
Abstract
The levels of squamous cell carcinoma antigen (SCC-Ag) and C-reactive protein (CRP) can be used to predict tumor invasion, lymph node metastasis, staging and survival in patients with oral cavity cancer. The present study analyzed the relationship between pre-treatment levels of SCC-Ag and CRP in relation to clinicopathological factors in patients with pharyngolaryngeal cancer (PLC) and determined whether elevated levels of CRP and SCC-Ag were associated with tumor metabolic activity via [18F] fluorodeoxyglucose positron emission tomography (FDG-PET). We retrospectively recruited one hundred and six PLC patients between June 2008 and December 2011. All patients received computed tomography (CT)/magnetic resonance imaging (MRI) and FDG-PET staging analyses, and the serum levels of SCC-Ag and CRP in these patients were measured prior to treatment. A SCC-Ag level ≥2.0 ng/ml and a CRP level ≥5.0 mg/L were significantly associated with clinical stage (P<0.001), clinical tumor status (P<0.001), and clinical nodal status (P<0.001). The elevation of both SCC-Ag and CRP levels was correlated with the standardized uptake value (SUV) max of the tumor (≥8.6 mg/L) and lymph nodes (≥5.7 ng/ml) (P = 0.019). The present study demonstrated that the presence of high levels of both pre-treatment SCC-Ag and CRP acts as a predictor of clinical stage, clinical tumor status, and clinical nodal status in patients with PLC. Moreover, elevated levels of SCC-Ag and CRP were associated with a high metabolic rate as well as the proliferative activity measured according to the SUVmax of the tumor and lymph nodes. Therefore, elevated levels of these two factors have the potential to serve as biomarkers for the prediction of tumor aggressiveness in cases of PLC.
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Affiliation(s)
- Hsuan-Ho Chen
- Departments of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Hung-Ming Wang
- Internal Medicine, Division of Hematology/Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Kang-Hsing Fan
- Radiation Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Chien-Yu Lin
- Radiation Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Tzu-Chen Yen
- Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Chun-Ta Liao
- Departments of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - I-How Chen
- Departments of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Chung-Jan Kang
- Departments of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Shiang-Fu Huang
- Departments of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
- * E-mail:
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