Amano M, Kato T
Department of Radiology, Cancer Institute Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 1997 Mar;57(4):176-81.
The purpose of this study was to assess the usefulness of MR imaging (MRI) in evaluating and predicting the effect of neoadjuvant chemotherapy on uterine cervical carcinoma. MRI was performed before and after neoadjuvant chemotherapy (NA-C) of systemic BOMP in 32 patients with cervical carcinoma. (1) In 8 patients who suffered from hysterectomy after NA-C, MR estimates of tumor diameter were within 5 mm of the surgical sample in all cases. In addition, MRI accurately evaluated parametrial state. (2) In 10 patients, the reduction rates after 2 courses of NA-C were compared with those after 3 courses, and no significant difference was found between them (p = 0.628). (3) Statistical analysis was performed to assess the correlation between the response to NA-C and MR findings before NA-C such as MR staging, tumor volume, signal intensity and contrast enhancement of tumor, body invasion, total cervical replacement, hydrometra, and ascites. Analysis of variance and multiregression analysis revealed that tumor volume (p = 0.012) and body invasion (p = 0.079) were important factors in predicting the effect of NA-C on cervical carcinoma. In conclusion, MRI is useful in evaluating and predicting the effect of NA-C on uterine cervical carcinoma.
本研究的目的是评估磁共振成像(MRI)在评估和预测新辅助化疗对子宫颈癌疗效方面的实用性。对32例宫颈癌患者进行了全身BOMP新辅助化疗(NA-C),化疗前后均行MRI检查。(1)在NA-C后接受子宫切除术的8例患者中,所有病例的肿瘤直径MRI估计值与手术标本相差均在5 mm以内。此外,MRI准确评估了宫旁组织状态。(2)在10例患者中,比较了2个疗程NA-C后的缩小率与3个疗程后的缩小率,两者之间未发现显著差异(p = 0.628)。(3)进行统计学分析以评估NA-C反应与NA-C前MRI表现之间的相关性,如MR分期、肿瘤体积、肿瘤信号强度和对比增强、宫体侵犯、宫颈完全被替代、宫腔积脓和腹水。方差分析和多元回归分析显示,肿瘤体积(p = 0.012)和宫体侵犯(p = 0.079)是预测NA-C对宫颈癌疗效的重要因素。总之,MRI在评估和预测NA-C对子宫颈癌的疗效方面是有用的。