Prediction And Prognostic Value Of Serum CA19-9 Levels In High-dose And Less-fractionated Radiotherapy Combined With Chemotherapy For Pancreatic Cancer

Objective: To observe the dynamic changes of serum CA19-9 level before and after the treatment of high-dose and less-fractionated radiotherapy combined with chemotherapy for pancreatic cancer,to explore the corresponding prognostic,predictive and therapeutic effects.Methods: The clinical features of 75 patients treated by high-dose,less-fractionated radiotherapy and chemotherapy in our department from November 2012 to July 2017 were retrospectively analyzed.Their survival was followed up.The level of serum CA19-9 was measured byelectrochemiluminescence(ECI).Analysis the degree of change of serum CA19-9 level on the prognosis between the before and after treatment.Results1.The median overall survival of 75 patients was 13.8 months(2.0 to 58.0 months).2.The median CA19-9 level before radiotherapy was 1 109 U/ml(4.70-70000U/ml)The cut-off value of baseline serum CA19-9 was 357.9U / ml by ROC curve.The Median Survival Time(MST)of the group withbaseline CA19-9?357.9U / ml to thegroup>357.9U / mlwas 17.5 to 10.5 months,the differences were statistically significant(P<0.05).Theprogression-free-survival(PFS)was 7.5 to 5.0 months,the differences were statistically significant(P <0.01).3.The median CA19-9 level in 4-6 weeks after radiotherapy was 397.7 U/ml(11.02-43250 U/ml).38 cases(38/49,77.6%)declined,11 cases(11/49,22.4%)raised.TheMST of the declined group to the raised group were 14.0 vs 8.0 months,the differences were statistically significant(P<0.01).The PFS was 5.5 vs 4.0 months,the differences were statistically significant(P<0.01).4.The ROC curve determined that the cut-off for the decline of serum CA19-9 was60.9% in 4 to 6 weeks after radiotherapy.The MST of ?60.9% group to <60.9%group was 33.5 vs 9.0 months,the differences were statistically significant(P<0.001).PFS were 11.0 vs 5.5 months,the differences were statistically significant(P<0.01).Conclusions In pancreatic cancer patients treated by high-dose less-fractionated Tomotherapy combined with chemotherapy,serum CA19-9 levels of prognostic evaluation is of great significance,and timely evaluation of the patient's treatment.Patients with baseline CA19-9 levels ?357.9 U / ml orthe decreased levels of CA19-9?60.9% in 4-6 weeks after radiotherapy had a better outcome.