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Three-Dimensional Power Doppler Ultrasound for Predicting Response and Local Recurrence After Concomitant Chemoradiation Therapy for Locally Advanced Carcinoma of the Cervix
  1. Juan Luis Alcazar, MD, PhD*,
  2. Sara Arribas, MD,
  3. Rafael Martinez-Monge, MD, PhD and
  4. Matias Jurado, MD, PhD*
  1. *Department of Obstetrics and Gynecology, School of Medicine, University of Navarra, Pamplona;
  2. Department of Obstetrics and Gynecology, Hospital Garcia Orcoyen, Estella; and
  3. Department of Radiation Oncology, School of Medicine, University of Navarra, Pamplona, Spain.
  1. Address correspondence and reprint requests to Juan Luis Alcazar, MD, PhD, School of Medicine, University of Navarra, Avenida Pio XII 36, 31008 Pamplona, Spain. E-mail: jlalcazar@unav.es.

Abstract

Objective The aim of this study was to assess the potential role of 3-dimensional power Doppler ultrasound (3D-PDUS) for predicting clinical response and recurrence after chemoradiotherapy in advanced-stage cervical cancer.

Methods This is a prospective study comprising a series of women with histological proven diagnosis of locally advanced stage (stage IB2-IVA) carcinoma of the cervix and submitted to chemoradiaton therapy. Before the start of chemoradiation therapy, all women were submitted to undergo transvaginal 3D-PDUS for assessing tumor volume and tumor vascularization. After finishing chemoradiation, all women were evaluated to assess clinical response. Complete clinical response was determined when no residual tumor was apparent. Partial clinical response (PCR) was determined when persistent residual tumor was observed and confirmed by histological analysis. Patients with PCR underwent salvage surgery. Local recurrence was defined as reappearance of the tumor within the pelvis at any time during follow-up.

Results Thirty-nine women (mean age, 50.3 years; ranging from 30 to 81 years) were included in the study. Complete clinical response was achieved in 29 women (70.7%), whereas 10 women (24.4%) had PCR. Eight women (20.5%) had local recurrence during follow-up. We did not find statistical significant differences in tumor size, volume, and vascularization between those women who had complete clinical response and those who had PCR and between those who had local recurrence and those who had not.

Conclusions A single 3D-PDUS assessment of tumor size and vascularization before treatment seems to be of limited value for predicting tumor response to chemoradiation therapy and for predicting tumor recurrence in women with locally advanced carcinoma of the cervix.

  • Cervix
  • Carcinoma
  • 3D
  • Doppler ultrasound
  • Chemoradiation

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Footnotes

  • The authors declare no conflicts of interest.

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