title: [Transvaginal color-Doppler sonography for monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical cancer].
abstract: Changes in blood flow characteristics, observed with transvaginal color-Doppler ultrasonography have recently been reported in patients with advanced cervical cancer. In order to evaluate the reliability of TVCDUS in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical cancer, a prospective study was undertaken on the blood flow characteristics of the cervical vessels. Pulsatility Index (PI) and Resistance Index (RI) of the uterine and cervical arteries of 12 patients with histologically proven advanced cervical cancer, scheduled for neoadjuvant chemotherapy were evaluated at diagnosis, during every cycle of chemotherapy and before surgery. A significantly lower value of mean PI and RI between cervical and uterine arteries was observed in patients with cervical cancer (PI = 1.671 +/- 0.18 vs 2.159 +/- 0.24)-(RI = 0.43 +/- 0.17 vs 0.72 +/- 0.22). Mean RI and mean PI of the descending branches of the uterine arteries were significantly lower in patients with cervical cancer, compared to healthy control women. No difference in blood flow parameters could be detected between stage I vs stage II-III, and between left and right cervical artery in patients with cervical cancer. Both RI and PI values appeared strictly related to the tumor response to chemotherapy. In fact in 8 patients in which treatment resulted in tumor regression, evaluated by pelvic examination and MR imaging, a significant (p < 0.01) increase of resistance indices was observed (PI = 1.671 +/- 0.18 vs 2.158 +/- 0.22)-(RI = 0.43 +/- 0.17 vs 0.79 +/- 0.16). On the other side 4 patients not responding to chemotherapy, had stable values of both PI and RI. Transvaginal color-Doppler ultrasonography might be useful in monitoring the response to neoadjuvant chemotherapy in patients with locally advanced cervical carcinoma.
authors.affiliation: Istituto di Patologia Ostetrica e Ginecologica R, Università degli Studi,Bari.
authors.forename: G
authors.initials: G
authors.lastname: Di Vagno
authors.forename: G
authors.initials: G
authors.lastname: Cormio
authors.forename: A
authors.initials: A
authors.lastname: Vimercati
authors.forename: G
authors.initials: G
authors.lastname: Nacci
authors.forename: P
authors.initials: P
authors.lastname: Greco
authors.forename: A
authors.initials: A
authors.lastname: Lepera
authors.forename: G
authors.initials: G
authors.lastname: Loverro
authors.forename: L
authors.initials: L
authors.lastname: Selvaggi
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000188:drug therapy; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D014621:Vagina
chemical_list: D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D001761:Bleomycin; D002945:Cisplatin; D008727:Methotrexate