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document
An explorative study on the clinical utility of baseline and serial serum tumour marker measurements in advanced upper gastrointestinal cancer . The value of early tumour marker changes during palliative chemotherapy in patients with upper gastrointestinal adenocarcinoma ( UGIA ) is unclear . Seventy-three patients with advanced UGIA were randomised to receive 45 mg/m2 docetaxel or 180 mg/m2 irinotecan with 5-FU/leucovorin . After every 2nd course the patients were crossed over to the other regimen . Serum was sampled before start of chemotherapy and every 2nd week during 8 weeks for CEA , TPA , TPS , CA72-4 , CA19-9 and CA242 measurements . Eighteen patients ( 25 % ) had partial response ( PR ) and 21 patients had stable disease for at least 4 months ( SD4 ) . All baseline marker levels , except CA72-4 , correlated with time to progression and survival . Patients with normal levels , except CA72-4 , also had more clinical responses ( PR+SD4 ) than patients with elevated values . Tumour marker changes early during treatment provided modest predictive information for tumour response and survival . A model combining baseline level , the change and the interaction between them gave the best prediction of outcome , however , insignificantly better than baseline level for all markers except CA242 . Baseline tumour marker levels provide prognostic information for patients with UGIA on palliative chemotherapy . Early changes generally failed to provide accurate information for tumour response and survival .
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Intervention_Pharmacological
docetaxel
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Intervention_Pharmacological
irinotecan with 5-FU/leucovorin
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Intervention_Pharmacological
crossed over to the other regimen
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Outcome_Physical
Serum
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Outcome_Physical
time to progression
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Outcome_Mortality
survival
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Outcome_Physical
Tumour marker changes
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Outcome_Physical
Baseline tumour marker
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Participant_Condition
advanced upper gastrointestinal cancer .
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Participant_Condition
patients with upper gastrointestinal adenocarcinoma ( UGIA )
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Participant_Sample-size
Seventy-three patients
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Participant_Condition
advanced UGIA
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Participant_Condition
Patients with normal levels , except CA72-4
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Participant_Condition
patients with UGIA on palliative chemotherapy