Ohno Tatsuya, Nakayama Yuko, Nakamoto Soken, Kato Shingo, Imai Reiko, Nonaka Tetsuo, Ishikawa Hitoshi, Harashima Koichi, Suzuki Yoshihiko
Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
Cancer. 2003 Jun 15;97(12):3114-20. doi: 10.1002/cncr.11453.
Optimal timing of the measurement of serum squamous cell carcinoma (SCC) antigen during radiation therapy (RT) and its significance for predicting the response of cervical carcinoma patients as early as possible remain unknown.
Sixty-three patients with SCC of the uterine cervix who received RT only were studied. Patients were treated with a combination of external beam irradiation and high-dose rate intracavitary irradiation. The serum SCC antigen level was measured before, every 2 or 3 weeks during, and 1 or 2 months after RT. Clinical outcome was divided into complete response and incomplete response.
Forty-seven patients (74.6%) had serum SCC antigen levels 1.5 ng/mL (the reference value) before RT. Normalization of serum SCC antigen levels at the end of RT were found to be significantly correlated with complete response in the SCC-positive patients. It was especially noted that in patients with serum SCC levels between 5-30 ng/mL before RT, a > 70% decrease in the serum SCC antigen level at 4 weeks was correlated significantly with complete response. In this group, a significant correlation also was found between a > 70% decrease in serum SCC level at 4 weeks and the normalization of SCC at the end of RT.
The current study data suggest that the serum SCC antigen level not only before, but also during and at the end of RT can predict the response of patients with cervical carcinoma and help in identifying those patients who are at high risk of local recurrence and/or distant metastasis.
放射治疗（RT）期间血清鳞状细胞癌（SCC）抗原测量的最佳时机及其对尽早预测宫颈癌患者反应的意义尚不清楚。
对仅接受RT的63例子宫颈SCC患者进行研究。患者接受外照射和高剂量率腔内照射联合治疗。在RT前、RT期间每2或3周以及RT后1或2个月测量血清SCC抗原水平。临床结局分为完全缓解和不完全缓解。
47例患者（74.6%）在RT前血清SCC抗原水平>1.5 ng/mL（参考值）。发现RT结束时血清SCC抗原水平正常化与SCC阳性患者的完全缓解显著相关。特别值得注意的是，在RT前血清SCC水平在5 - 30 ng/mL之间的患者中，4周时血清SCC抗原水平下降>70%与完全缓解显著相关。在该组中，4周时血清SCC水平下降>70%与RT结束时SCC正常化之间也发现显著相关性。
目前的研究数据表明，血清SCC抗原水平不仅在RT前，而且在RT期间和结束时都可以预测宫颈癌患者的反应，并有助于识别那些有局部复发和/或远处转移高风险的患者。
