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学科主题: 临床医学
题名:
Prognostic value of pretreatment level of carcinoembryonic antigen on tumour downstaging and early occurring metastasis in locally advanced rectal cancer following neoadjuvant radiotherapy (30 Gy in 10 fractions)
作者: Wang, L.1; Zhong, X. -G.2; Peng, Y. -F.1; Li, Z. -W.3; Gu, J.1
关键词: Carcinoembryonic antigen ; rectal cancer ; neoadjuvant radiotherapy ; tumour downstaging ; metastasis
刊名: COLORECTAL DISEASE
发表日期: 2014
DOI: 10.1111/codi.12354
卷: 16, 期:1, 页:33-39
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Gastroenterology & Hepatology ; Surgery
研究领域[WOS]: Gastroenterology & Hepatology ; Surgery
关键词[WOS]: TOTAL MESORECTAL EXCISION ; PREOPERATIVE RADIOTHERAPY ; COLORECTAL-CANCER ; RANDOMIZED-TRIAL ; CHEMORADIOTHERAPY ; CHEMORADIATION ; RECOMMENDATIONS ; MULTICENTER ; PREDICTION ; MERCURY
英文摘要:

Aim To evaluate the role of carcinoembryonic antigen (CEA) in predicting the response to and prognosis for locally advanced rectal cancer treated with 30Gy neoadjuvant radiotherapy (nRT) in 10 fractions (30Gy/10f).

MethodThis retrospective study involved 240 patients with locally advanced rectal cancer who underwent 30Gy/10f nRT (biologically equivalent dose 36Gy) followed by total mesorectal excision between August 2003 and 2009. Serum CEA level was determined before administration of nRT. The prognostic value of serum CEA level on tumour downstaging and 3-year disease-free survival was analysed.

ResultsNinety out of 240 (37.5%) patients had elevated CEA levels before nRT. The incidence of T downstaging in patients decreased significantly as the pretreatment CEA levels became more elevated (<5ng/ml, 50.7%; 5-10ng/ml, 39.5%; >10ng/ml, 17.3%; P=0.00014). Downstaging to ypCR or ypStage I occurred in 46.7% (66/150) of patients with a CEA level of <5ng/ml and 34.2% (13/38) of patients with a CEA level of 5-10ng/ml. In contrast, just 13.5% (7/52) of those with a CEA level>10ng/ml downstaged to ypStage I and none of them achieved ypCR, with statistical difference (P=0.001). A significantly higher incidence of early metastasis (within 6 postoperative months) was observed with increasing CEA level: 2.0% (3/150), 5.4% (2/38) and 11.5% (6/52) in patients with CEA level<5ng/ml, 5-10ng/ml or >10ng/ml, respectively (P=0.018).

ConclusionPretreatment CEA level cannot only predict tumour downstaging and ypTNM stage for rectal cancer following 30Gy/10f nRT, but also promisingly suggests a high incidence of early occurring distant metastasis. These findings may be used to select patients with nRT resistance and occult metastasis and make alternative treatment strategies.

语种: 英语
WOS记录号: WOS:000328293400012
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/53797
Appears in Collections:北京大学临床肿瘤学院_胃肠肿瘤中心_期刊论文

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作者单位: 1.Peking Univ Canc Hosp & Inst, Minist Educ, Key Lab Carcinogenesis & Translat Res, Dept Colorectal Surg, Beijing, Peoples R China
2.Peoples Hosp Guangxi Zhuang Autonomous Reg, Dept Gastrointestinal Surg, Nanning, Peoples R China
3.Peking Univ Canc Hosp & Inst, Dept Pathol, Key Lab Carcinogenesis & Translat Res, Minist Educ, Beijing, Peoples R China

Recommended Citation:
Wang, L.,Zhong, X. -G.,Peng, Y. -F.,et al. Prognostic value of pretreatment level of carcinoembryonic antigen on tumour downstaging and early occurring metastasis in locally advanced rectal cancer following neoadjuvant radiotherapy (30 Gy in 10 fractions)[J]. COLORECTAL DISEASE,2014,16(1):33-39.
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