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Kinetics of serum squamous cell carcinoma antigen (SCC-Ag) during radiotherapy as an independent prognostic marker in carcinoma of the cervix
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Y. Zhang   , Z. Gong , M. Yu , Y. Liu |
| Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences Obstetrics and Gynecology, Chongming, Shanghai, China , 18976283664@163.com |
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Abstract: (30 Views) |
Background: Serum squamous cell carcinoma antigen (SCC-Ag) is a established pretreatment prognostic marker in cervical squamous cell carcinoma (SCC). However, the prognostic value of its serial measurement during curative-intent radiotherapy (RT) is not well defined. The aim of this study is to evaluate whether the kinetics of serum SCC-Ag during definitive RT/chemoradiotherapy (CRT) are independently predictive of locoregional control (LRC) and overall survival (OS). Materials and Methods: This prospective cohort analysis included patients diagnosed with histologically verified cervical SCC who received definitive RT, either alone or combined with concurrent chemotherapy. Serum SCC-Ag concentrations were assessed at baseline (T0), mid-treatment (T1), and post-therapy completion (T2). Participants were categorized into three groups based on SCC-Ag dynamics: rapid normalizers, slow normalizers, and non-normalizers. Key outcomes were 3-year LRC and OS, evaluated via Kaplan-Meier methods and Cox proportional hazards regression. Results: Median follow-up duration was 42 months. Three-year LRC rates were 89.5% for rapid normalizers, 76.2% for slow normalizers, and 43.3% for non-normalizers (p<0.001). Similarly, 3-year OS rates stood at 91.8%, 79.4%, and 46.7%, respectively (p<0.001). Multivariable analysis identified SCC-Ag kinetic profile as the most robust independent predictor of OS (HR for non-normalizers vs. rapid normalizers: 5.12, 95% CI 2.68-9.78, p<0.001) and LRC (HR: 4.85, 95% CI 2.51-9.38, p<0.001), controlling for FIGO stage, lymph node involvement, and tumor dimensions. Conclusion: The failure of serum SCC-Ag to normalize during radiotherapy is a powerful, independent indicator of poor prognosis. Serial SCC-Ag monitoring provides a dynamic, clinically accessible biomarker for early identification of high-risk patients who may benefit from treatment intensification. |
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| Keywords: Cervical cancer, squamous cell carcinoma antigen (SCC-Ag), radiotherapy, kinetics, prognostic marker, chemoradiation, biomarker. |
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Full-Text [PDF 772 kb]
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Type of Study: Original Research |
Subject:
Radiation Biology
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