[The monitoring of gynecological radiotherapy using serial tumor marker determinations]

In 149 collum and 45 corpus carcinomas tumor marker concentrations in serum have been measured before, during and sex to eight weeks after termination of radiotherapy. For the collum carcinomas (average of FIGO I to IV) the sensitivity of CEA was found to be 51%, SCC 67%, CEA +SCC 80%. In corpus carcinomas CEA had low sensitivity and could not readily be used for therapy monitoring. However, in a number of cases CA125 was a good substitute. Six to eight weeks after termination of radiotherapy the average tumor marker levels have been declined by comparison with the pretherapeutic values (100%): For the collum carcinoma CEA dropped to 39%, SCC to 57%; for the corpus carcinoma CEA to 72%, CA 125 to 81%. The highest diagnostic information was gained by comparison of post-therapeutical tumor-marker levels with cut off values obtained from healthy women of the same age group. After treatment in 29 of 106 collum carcinomas CEA and or SCC levels did still exceed these cut off values. In eleven cases this marker elevation was due to paraaortic lymph node metastases, in seven cases a local tumor residue was discovered and in six cases general metastases. In corpus carcinomas the main reason for post-therapeutic elevated CA125 values also were paraaortic lymph node metastases. Thus, the use of serial tumor marker determination for control of gynecological radiotherapy is a helpful tool in early detecting local tumor residues and metastases. The decision making for further radiotherapeutical measures will be much easier, if accompanying tumor marker determinations have been done during primary radiotherapy.