Clinical impact of CYFRA 21-1 as a marker for treatment failure in patients with oropharyngeal cancer and primary radio(chemo)therapy

Introduction Primary radio(chemo)therapy (RCT) is a treatment option for patients with advanced oropharyngeal squamous cell carcinoma (OSCC). However early diagnostics of treatment failure remains problematic. In this context, a tumor marker as Cytokeratin 19 fragment (CYFRA 21-1), which is established in the management of lung cancer, might be useful. Thus, in the present study we analyzed the clinical impact of CYFRA 21-1 as a marker for treatment failure in patients with OSCC after RCT.

Methods The clinical and histological data of overall 80 patients with advanced OSCC and RCT were retrospectively analyzed. In all cases, CYFRA 21-1 serum levels were evaluated by ECLIA assay at time of diagnosis and after RCT. Tumor residuals were pathologically confirmed after detection by computer tomography or panendoscopy. The mean follow-up time was 22.2 month.

Results Altogether 47 (59 %) patients experienced loco-regional control and 33 (41 %) patients suffered from loco-regional failure after RCT. There was no statically difference between the CYFRA 21-1 serum concentration between the two groups before or after RCT. However, the CYFRA 21-1 serum concentration during the first follow-up was significantly elevated among patients with tumor recurrence in the further course of the disease (mean concentration 5.8 ng/ml) compared to patients, who were tumor free (mean concentration 2.2 ng/ml) (p= 0.00). After RCT, the occurrence of tumor recurrence was significantly associated with the CYFRA 21-1 serum concentration in univariate analysis (p = 0.02).

Conclusion CYFRA 21-1 seems not to be suitable marker for early detection of treatment failure after RCT of OSCC. However, elevated serum levels in the further course may be associated with tumor recurrence after RCT.

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Publication History

Article published online:
10 June 2020