title: Effects of external radiotherapy on uterine blood flow in patients with advanced cervical carcinoma assessed by color Doppler ultrasonography.
abstract: BACKGROUND
  This study was designed to evaluate radiation-induced changes in tumor blood flow by color Doppler ultrasonography.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Pirhonen
authors.forename: S A
authors.initials: SA
authors.lastname: Grenman
authors.forename: A B
authors.initials: AB
authors.lastname: Bredbacka
authors.forename: R O
authors.initials: RO
authors.lastname: Bahado-Singh
authors.forename: T A
authors.initials: TA
authors.lastname: Salmi
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001783:Blood Flow Velocity / Q000528:radiation effects; D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D018615:Ultrasonography, Doppler, Color; D002583:Uterine Cervical Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000532:radiotherapy*