Department of Gynecology and Obstetrics, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Int J Gynecol Cancer. 2013 Sep;23(7):1270-8. doi: 10.1097/IGC.0b013e31829db950.
The objective of this study was to evaluate the dynamic changes of blood perfusion coinciding with tumor regression after neoadjuvant chemotherapy (NACT) in locally advanced cervical cancer (LACC).
Thirty patients with LACC received conventional 3.0-T magnetic resonance imaging and perfusion-weighted imaging scans at 3 different times (before NACT, 2 weeks after the first NACT, and 2 weeks after the second NACT). Characteristics of time-intensity diagrams and patterns of blood perfusion maps according to the parameter of area under the curve (AUC) were observed. Eight perfusion parameters were compared among 3 time points at 2 different chemotherapy-sensitive groups by the software of Basic T1 Perfusion.
The effective chemotherapy rate was 73.3% (22/30). The characteristic of time-intensity diagrams in cervical cancer was a rapid onset with plateau. There were 3 patterns of AUC perfusion maps. The common perfusion map was rich blood supply type in the effective chemotherapy group and peripheral blood supply type in the ineffective chemotherapy group. Four parameter values (relative enhancement, maximum enhancement, wash-in rate, and AUC) were significantly reduced 2 weeks after the second NACT than those before the therapy (P = 0.000; P = 0.009; P = 0.011; and P = 0.000) in the effective chemotherapy group, especially the value of relative enhancement 2 weeks after the first NACT, was obviously decreased compared to that before the therapy (P = 0.042). The value of time to peak 2 weeks after the second NACT was significantly longer than that before the therapy in the effective chemotherapy group (P = 0.001). There were no obvious changes of blood perfusion parameters among the 3 different times in the ineffective chemotherapy group.
Tumor blood perfusion has obviously decreased after effective NACT in the treatment of LACC.
本研究旨在评估新辅助化疗（NACT）后局部晚期宫颈癌（LACC）肿瘤退缩时的血液灌注动态变化。
30 例 LACC 患者分别在 NACT 前、首次 NACT 后 2 周、再次 NACT 后 2 周接受常规 3.0T 磁共振成像和灌注加权成像扫描。观察时间-强度曲线的特征和根据曲线下面积（AUC）参数的血流灌注图模式。使用 Basic T1 Perfusion 软件比较 2 种不同化疗敏感组 3 个时间点的 8 个灌注参数。
有效化疗率为 73.3%（22/30）。宫颈癌的时间-强度曲线特征为快速上升和平台期。AUC 灌注图有 3 种模式。有效的化疗组常见的灌注图为富血供型，无效的化疗组为外周血供型。有效化疗组中，再次 NACT 后 2 周的 4 个参数值（相对增强、最大增强、灌注率和 AUC）均显著低于治疗前（P=0.000；P=0.009；P=0.011；P=0.000），特别是首次 NACT 后 2 周的相对增强值明显低于治疗前（P=0.042）。有效化疗组再次 NACT 后 2 周的达峰时间明显长于治疗前（P=0.001）。无效化疗组在 3 个不同时间点的血流灌注参数均无明显变化。
LACC 经有效 NACT 治疗后肿瘤血供明显减少。
