Pirhonen J P, Grenman S A, Bredbacka A B, Bahado-Singh R O, Salmi T A
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, USA.
Cancer. 1995 Jul 1;76(1):67-71. doi: 10.1002/1097-0142(19950701)76:1<67::aid-cncr2820760109>3.0.co;2-0.
This study was designed to evaluate radiation-induced changes in tumor blood flow by color Doppler ultrasonography.
Color Doppler examination was performed on 14 patients with advanced cervical carcinoma treated with external radiotherapy. The total dose of radiation varied from 30 to 65 Gy and was given as 1.9 Gy daily fractions, 5 days/week. Tumor vascularity and blood flow impedance were measured by one pretreatment and five follow-up examinations.
At the baseline examination, 11 of 14 patients had very low tumor blood flow impedance (< 0.70). Radiotherapy caused a significant decrease in tumor vascularity (P = 0.0001) and in presence of very low blood flow impedance. The decrease of tumor vascularity during the treatment was associated with better outcome, whereas persistence of excessive vascularity or of vessels with low blood flow impedance at the end of radiation was associated with modest therapeutic response. Eight of 10 patients with increased tumor vascularity at the end of radiation needed further treatment or died of disease. Only one of four patients with normal vasculature at the end of radiotherapy needed further treatment and all four were clinically disease free during the follow-up (mean, 13 months; range, 6-26 months).
These results suggest that color Doppler ultrasonography may be useful in early assessment of therapeutic response during radiotherapy and in for planning individualized treatment schedules.
本研究旨在通过彩色多普勒超声评估辐射诱导的肿瘤血流变化。
对14例接受体外放射治疗的晚期宫颈癌患者进行彩色多普勒检查。放射总剂量为30至65 Gy，每日分次剂量为1.9 Gy，每周5天。在治疗前及五次随访检查中测量肿瘤血管生成和血流阻抗。
在基线检查时，14例患者中有11例肿瘤血流阻抗非常低（<0.70）。放射治疗导致肿瘤血管生成显著减少（P = 0.0001）以及极低血流阻抗的出现。治疗期间肿瘤血管生成的减少与更好的预后相关，而在放疗结束时过度血管生成或低血流阻抗血管持续存在与适度的治疗反应相关。放疗结束时肿瘤血管生成增加的10例患者中有8例需要进一步治疗或死于疾病。放疗结束时血管生成正常的4例患者中只有1例需要进一步治疗，且所有4例在随访期间（平均13个月；范围6 - 26个月）临床无疾病。
这些结果表明，彩色多普勒超声可能有助于放疗期间治疗反应的早期评估以及制定个体化治疗方案。
