EFFECTS OF EXTERNAL RADIOTHERAPY ON UTERINE BLOOD-FLOW IN PATIENTS WITH ADVANCED CERVICAL-CARCINOMA ASSESSED BY COLOR DOPPLER ULTRASONOGRAPHY

Background. This study was designed to evaluate radiation-induced chan ges in tumor blood flow by color Doppler ultrasonography. Methods. Col or Doppler examination was performed on 14 patients with advanced cerv ical carcinoma treated with external radiotherapy. The total dose of r adiation varied from 30 to 65 Gy and was given as 1.9 Gy daily fractio ns, 5 days/week. Tumor vascularity and blood flow impedance were measu red by one pretreatment and five follow-up examinations. Results. At t he baseline examination, 11 of 14 patients had very low tumor blood fl ow impedance (<0.70). Radiotherapy caused a significant decrease in tu mor vascularity (P = 0.0001) and in presence of very low blood flow im pedance. The decrease of tumor vascularity during the treatment was as sociated with better outcome, whereas persistence of excessive vascula rity or of vessels with low blood flow impedance at the end of radiati on was associated with modest therapeutic response. Eight of 10 patien ts with increased tumor vascularity at the end of radiation needed fur ther treatment or died of disease. Only one of four patients with norm al vasculature at the end of radiotherapy needed further treatment and all four were clinically disease free during the follow-up (mean, 13 months; range. Conclusions. These results suggest that color Doppler u ltrasonography may be useful in early assessment of therapeutic respon se during radiotherapy and in for planning individualized treatment sc hedules.