CA 19-9 in the therapy monitoring and follow-up of locally advanced cancer of the exocrine pancreas treated with radiochemotherapy.
OBJECTIVE
The aim of this study was to determine the value of CA 19-9 in therapy monitoring and follow-up of locally advanced pancreatic cancer treated by radiochemotherapy.


METHODS
Ninety-five patients with locally advanced irresectable adenocarcinoma of the pancreas were treated with hyperfractionated accelerated radiotherapy, with 44.8 Gy and 5-fluorouracil and folinic acid, January 1994 between and June 2001. CA 19-9 was measured before therapy, each week under therapy and every 4 weeks in the follow-up.


RESULTS
Median CA 19-9 before treatment was 420 U/ml. Patients with a level below the median had significantly better prognosis and a better treatment response than those above the median. In the follow-up CA 19-9 had a sensitivity of 100% in detection of recurrent disease with a specificity of 88.


CONCLUSIONS
CA 19-9 has a high prognostic value and may serve as an in vivo marker for treatment sensitivity. For detection of recurrent disease it shows a high sensitivity and specificity.
Micke
Oliver
O
Klinik und Poliklinik für Strahlentherapie-Radioonkologie, Universitätsklinikum Münster, 48129 Münster, Germany. omicke@uni-muenster.de
Bruns
Frank
F
Schäfer
Ulrich
U
Kurowski
Rene
R
Horst
Eckehard
E
Willich
Norman
N
D000230:Adenocarcinoma / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality; D000328:Adult; D000368:Aged; D018395:CA-19-9 Antigen / Q000097:blood*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D011859:Radiography; D016019:Survival Analysis; D013997:Time Factors
D018395:CA-19-9 Antigen; D002955:Leucovorin; D005472:Fluorouracil