Prognostic Value of Pretreatment Carcinoembryonic Antigen (CEA) in Rectal Cancer Treated with Preoperative Short-Course Radiotherapy with Delayed Surgery or Long-Course Radiotherapy.

IF 2.7 4区医学 Q3 BIOTECHNOLOGY & APPLIED MICROBIOLOGY OncoTargets and therapy Pub Date : 2025-01-16 eCollection Date: 2025-01-01 DOI:10.2147/OTT.S474855

Yun-Hsuan Lin, Hsuan-Chih Hsu, Eng-Yen Huang

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Abstract

Purpose: To investigate the prognostic value of the pretreatment serum carcinoembryonic antigen (CEA) level in patients with rectal cancer treated by preoperative short-course radiotherapy (SCRT) followed by chemotherapy and delayed surgery.

Patients and methods: Two hundred and sixty-six consecutive patients with locally advanced rectal adenocarcinoma without distant metastasis receiving preoperative radiotherapy were enrolled. Group 1 patients (n=144) received long-course radiotherapy (LCRT) with 50.4 Gy in 28 fractions using photon radiotherapy (XRT). Group 2 patients (n=122) received SCRT with 25 Gy in 5 fractions using XRT or proton beam therapy (PBT) followed by chemotherapy and delayed surgery. Pathological complete response (pCR), near pathological complete response (npCR), locoregional recurrence (LRR), distant metastasis (DM), disease-specific survival (DSS) and overall survival (OS) rates were estimated and compared to scrutinize the prognostic significance of factors including CEA level.

Results: In group 1, higher CEA level (≥ 7 ng/mL) was a significant negative prognostic factor of pCR (p = 0.003, OR: 0.133), OS (p = 0.011, HR: 2.999), DM (p = 0.008, HR: 2.569), LRR (p = 0.044, HR: 3.160), and DSS (p = 0.015, HR: 3.273). In group 2, higher CEA level (≥ 7 ng/mL) was a significant negative prognostic factor of pCR (p = 0.002, OR: 0.038), OS (p < 0.001, HR: 44.658), DM (p < 0.001, HR: 8.926), LRR (p = 0.028, HR: 8.570), and DSS (p = 0.001, HR: 43.918). The npCR rates for clinical T4 patients were 6.5% and 22.0% (p = 0.032), in group 1 and group 2, respectively.

Conclusion: This study elucidates the prognostic merit of the pretreatment serum CEA level in patients with rectal cancer treated by either preoperative LCRT or SCRT followed by chemotherapy and delayed surgery.

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前处理癌胚抗原（CEA）在直肠癌术前短期放疗伴延迟手术或长期放疗中的预后价值。

目的：探讨经术前短程放疗（SCRT）后化疗及延迟手术治疗的直肠癌患者术前血清癌胚抗原（CEA）水平对预后的影响。患者和方法：连续266例局部晚期无远处转移的直肠腺癌患者接受术前放疗。第1组144例患者采用光子放射治疗（XRT），采用28次50.4 Gy的长疗程放射治疗（LCRT）。第2组患者（122例）接受5次25 Gy的SCRT， XRT或质子束治疗（PBT），随后化疗和延迟手术。评估病理完全缓解（pCR）、近病理完全缓解（npCR）、局部复发（LRR）、远处转移（DM）、疾病特异性生存（DSS）和总生存（OS）率，并进行比较，以探讨CEA水平等因素对预后的意义。结果：1组CEA水平升高（≥7 ng/mL）是pCR （p = 0.003, OR: 0.133）、OS （p = 0.011, HR: 2.999）、DM （p = 0.008, HR: 2.569）、LRR （p = 0.044, HR: 3.160）、DSS （p = 0.015, HR: 3.273）的显著负向预后因素。2组CEA升高（≥7 ng/mL）是pCR （p = 0.002, OR: 0.038）、OS （p < 0.001, HR: 44.658）、DM （p < 0.001, HR: 8.926）、LRR （p = 0.028, HR: 8.570）、DSS （p = 0.001, HR: 43.918）的显著负向预后因素。临床T4患者的npCR率1组为6.5%，2组为22.0% （p = 0.032）。结论：本研究阐明了术前LCRT或SCRT治疗后化疗和延迟手术的直肠癌患者的预处理血清CEA水平的预后价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

OncoTargets and therapy BIOTECHNOLOGY & APPLIED MICROBIOLOGY-ONCOLOGY

CiteScore

9.70

自引率

0.00%

发文量

221

审稿时长

1 months

期刊介绍： OncoTargets and Therapy is an international, peer-reviewed journal focusing on molecular aspects of cancer research, that is, the molecular diagnosis of and targeted molecular or precision therapy for all types of cancer. The journal is characterized by the rapid reporting of high-quality original research, basic science, reviews and evaluations, expert opinion and commentary that shed novel insight on a cancer or cancer subtype. Specific topics covered by the journal include: -Novel therapeutic targets and innovative agents -Novel therapeutic regimens for improved benefit and/or decreased side effects -Early stage clinical trials Further considerations when submitting to OncoTargets and Therapy: -Studies containing in vivo animal model data will be considered favorably. -Tissue microarray analyses will not be considered except in cases where they are supported by comprehensive biological studies involving multiple cell lines. -Biomarker association studies will be considered only when validated by comprehensive in vitro data and analysis of human tissue samples. -Studies utilizing publicly available data (e.g. GWAS/TCGA/GEO etc.) should add to the body of knowledge about a specific disease or relevant phenotype and must be validated using the authors’ own data through replication in an independent sample set and functional follow-up. -Bioinformatics studies must be validated using the authors’ own data through replication in an independent sample set and functional follow-up. -Single nucleotide polymorphism (SNP) studies will not be considered.