en Radiation Biology Radiation Biology تحقيق بديع Original Research <div style="text-align: justify;"><span style="font-size:10pt"><span style="text-justify:newspaper"><span style="text-kashida-space:50%"><span style="line-height:119%"><span style="font-family:Calibri"><span style="color:black"><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Background:</span></span></span></span></span></span> <span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">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). </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Materials and Methods:&nbsp; </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">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. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Results:&nbsp;</span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">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. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Conclusion:&nbsp;</span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">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.</span></span></span></span></span></span></span></span></span></div> Cervical cancer, squamous cell carcinoma antigen (SCC-Ag), radiotherapy, kinetics, prognostic marker, chemoradiation, biomarker. 1109 1114 http://ijrr.com/browse.php?a_code=A-10-1-1622&slc_lang=en&sid=1 Y. Zhang 7900319475328460035042 7900319475328460035042 No Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences Obstetrics and Gynecology, Chongming, Shanghai, China Z. Gong 7900319475328460035043 7900319475328460035043 No Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences Obstetrics and Gynecology, Chongming, Shanghai, China M. Yu 7900319475328460035044 7900319475328460035044 No Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences Obstetrics and Gynecology, Chongming, Shanghai, China Y. Liu 18976283664@163.com 7900319475328460035045 7900319475328460035045 Yes Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences Obstetrics and Gynecology, Chongming, Shanghai, China