Alcázar Juan Luis, Castillo Gerardo, Martínez-Monge Rafael, Jurado Matías
Department of Obstetrics and Gynecology, School of Medicine, University of Navarra, Avenida Pio XII, 36, 31008, Pamplona, Spain.
J Clin Ultrasound. 2004 Jul-Aug;32(6):267-72. doi: 10.1002/jcu.20033.
This study was conducted to evaluate the potential role of transvaginal color Doppler sonography (TVCD) in predicting response to concurrent chemoradiotherapy for locally advanced cervical cancer.
Tumor vascularity was assessed using TVCD before the start of concurrent chemoradiotherapy in 21 patients (median age, 47 years; range, 31-75 years) with histologically proven locally advanced cervical cancer. The lowest resistance index (RI), lowest pulsatility index (PI), and highest peak systolic velocity (PSV) from central vessels within the tumor were recorded and used for analysis. All patients were clinically evaluated by physical examination and CT scanning after completing the chemoradiotherapy protocol. Complete clinical response (CR) was determined when no residual tumor was found. Partial clinical response (PR) was determined when the tumor volume had decreased more than 50%.
CR was achieved in 11 patients (52%), whereas 10 (48%) had PR. The initial median tumor volume was not statistically different between those with CR (26 cm3) and those with PR (28 cm3) (p = 0.71). RI was higher in those tumors with CR (median, 0.47) than in those with PR (median, 0.29) (p < 0.01). Likewise, PI was higher in tumors with CR (median, 0.81) than in those with PR (median, 0.41) (p < 0.01). No differences were found in PSV. The likelihood ratio for CR for tumors with a lowest RI of 0.35 or more was 2.7 (95% confidence interval, 1.8-3.6) and the likelihood ratio for CR for tumors with a lowest PI of 0.45 or more was 3.3 (95% confidence interval, 2.1-4.5).
The results suggest that TVCD may be useful in predicting clinical response to concurrent chemoradiation in patients with locally advanced cervical cancer.
本研究旨在评估经阴道彩色多普勒超声检查（TVCD）在预测局部晚期宫颈癌同步放化疗疗效方面的潜在作用。
对21例经组织学证实为局部晚期宫颈癌的患者（中位年龄47岁；范围31 - 75岁）在同步放化疗开始前使用TVCD评估肿瘤血管情况。记录肿瘤中心血管的最低阻力指数（RI）、最低搏动指数（PI）和最高收缩期峰值速度（PSV）并用于分析。所有患者在完成放化疗方案后进行临床体格检查和CT扫描评估。当未发现残留肿瘤时确定为完全临床缓解（CR）。当肿瘤体积缩小超过50%时确定为部分临床缓解（PR）。
11例患者（52%）达到CR，而10例（48%）为PR。CR患者（26 cm³）和PR患者（28 cm³）的初始中位肿瘤体积无统计学差异（p = 0.71）。CR肿瘤的RI（中位值0.47）高于PR肿瘤（中位值0.29）（p < 0.01）。同样，CR肿瘤的PI（中位值0.81）高于PR肿瘤（中位值0.41）（p < 0.01）。PSV未发现差异。最低RI为0.35或更高的肿瘤CR的似然比为2.7（95%置信区间，1.8 - 3.6），最低PI为0.45或更高的肿瘤CR的似然比为3.3（95%置信区间，2.1 - 4.5）。
结果表明TVCD可能有助于预测局部晚期宫颈癌患者同步放化疗的临床疗效。
