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The Predictive Value of Tumor Size, Volume, and Markers During Radiation Therapy in Patients With Cervical Cancer
  1. Kyu Chan Lee, MD,
  2. Hun Jung Kim, MD,
  3. KiHoon Sung, MD,
  4. Young Eun Choi, PhD,
  5. Seok Ho Lee, MD,
  6. Soyi Lim, MD,
  7. Kwang Beom Lee, MD,
  8. Jin Woo Shin, MD,
  9. Chan Yong Park, MD,
  10. Young Saing Kim, MD,
  11. Sun Jin Sym, MD,
  12. Young Sup Shim, MD and
  13. Seung Joon Choi, MD
  1. * Department of Radiation Oncology, Gachon University of Medical and Science;
  2. Department of Radiation Oncology, Inha University Hospital, Inha University School of Medicine; and Departments of
  3. Obstetrics and Gynecology,
  4. § Medicine, and
  5. Radiology, Gachon University Gil Medical Center, Incheon, Korea.
  1. Address correspondence and reprint requests to Seok Ho Lee, MD, 1198 Guwol-dong, Namdong-gu, Incheon 405-760, Korea. E-mail: souko{at}


Objectives We investigated the prognostic significance of changes in primary tumor volume and serum squamous cell carcinoma antigen (SCC-ag) levels during radiation therapy (RT) in patients with cervical cancer.

Methods We conducted a review of 40 patients treated with RT. All patients received external beam RT and intracavitary brachytherapy. The primary tumor volume and squamous cell carcinoma antigen levels were measured pre-RT and mid-RT. Overall survival (OS) and progression free survival (PFS) were estimated, and possible prognostic factors for survival were analyzed.

Results The correlation coefficient between primary tumor volume reduction rate (pTVRR) and serum squamous cell carcinoma antigen reduction rate in all patients was 0.550 (P < 0.001). In univariate analysis, stage more than II (P <0.001), pre-RT pTV of 55 cm3 or more (P = 0.05), mid-RT tumor size of 4 cm or more (P = 0.004), and pTVRR of 90% or less (P = 0.031) were significant unfavorable prognostic factors for PFS, whereas stage (P = 0.009) was the only significant prognostic factor for OS. Multivariable analysis revealed that none of these factors were independently associated with PFS or OS.

Conclusions There was a significant correlation between pTVRR and squamous cell carcinoma antigen reduction rate. Our findings indicate that the tumor parameters such as pre-RT pTV, mid-RT tumor size, and pTVRR are associated with PFS in women with cervical cancer.

  • Cervix cancer
  • Radiation therapy
  • Tumor volume
  • Squamous cell carcinoma antigen

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  • The authors declare no conflicts of interest.