{"title":"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。","authors":"Yun-Hsuan Lin, Hsuan-Chih Hsu, Eng-Yen Huang","doi":"10.2147/OTT.S474855","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Results: </strong>In group 1, higher CEA level (≥ 7 ng/mL) was a significant negative prognostic factor of pCR (<i>p</i> = 0.003, OR: 0.133), OS (<i>p</i> = 0.011, HR: 2.999), DM (<i>p</i> = 0.008, HR: 2.569), LRR (<i>p</i> = 0.044, HR: 3.160), and DSS (<i>p</i> = 0.015, HR: 3.273). In group 2, higher CEA level (≥ 7 ng/mL) was a significant negative prognostic factor of pCR (<i>p</i> = 0.002, OR: 0.038), OS (<i>p</i> < 0.001, HR: 44.658), DM (<i>p</i> < 0.001, HR: 8.926), LRR (<i>p</i> = 0.028, HR: 8.570), and DSS (<i>p</i> = 0.001, HR: 43.918). The npCR rates for clinical T4 patients were 6.5% and 22.0% (<i>p</i> = 0.032), in group 1 and group 2, respectively.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"73-86"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748052/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prognostic Value of Pretreatment Carcinoembryonic Antigen (CEA) in Rectal Cancer Treated with Preoperative Short-Course Radiotherapy with Delayed Surgery or Long-Course Radiotherapy.\",\"authors\":\"Yun-Hsuan Lin, Hsuan-Chih Hsu, Eng-Yen Huang\",\"doi\":\"10.2147/OTT.S474855\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Results: </strong>In group 1, higher CEA level (≥ 7 ng/mL) was a significant negative prognostic factor of pCR (<i>p</i> = 0.003, OR: 0.133), OS (<i>p</i> = 0.011, HR: 2.999), DM (<i>p</i> = 0.008, HR: 2.569), LRR (<i>p</i> = 0.044, HR: 3.160), and DSS (<i>p</i> = 0.015, HR: 3.273). In group 2, higher CEA level (≥ 7 ng/mL) was a significant negative prognostic factor of pCR (<i>p</i> = 0.002, OR: 0.038), OS (<i>p</i> < 0.001, HR: 44.658), DM (<i>p</i> < 0.001, HR: 8.926), LRR (<i>p</i> = 0.028, HR: 8.570), and DSS (<i>p</i> = 0.001, HR: 43.918). The npCR rates for clinical T4 patients were 6.5% and 22.0% (<i>p</i> = 0.032), in group 1 and group 2, respectively.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":19534,\"journal\":{\"name\":\"OncoTargets and therapy\",\"volume\":\"18 \",\"pages\":\"73-86\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-01-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748052/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"OncoTargets and therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/OTT.S474855\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"BIOTECHNOLOGY & APPLIED MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"OncoTargets and therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/OTT.S474855","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"BIOTECHNOLOGY & APPLIED MICROBIOLOGY","Score":null,"Total":0}
Prognostic Value of Pretreatment Carcinoembryonic Antigen (CEA) in Rectal Cancer Treated with Preoperative Short-Course Radiotherapy with Delayed Surgery or Long-Course Radiotherapy.
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.
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.
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