Transvaginal color Doppler for predicting pathological response to preoperative chemoradiation in locally advanced cervical carcinoma: A preliminary study

To evaluate the role of transvaginal color Doppler ultrasonography (TCD) in predicting pathological response to prf operative chemoradiation in patien ts with locally advanced cervical cancer, 10 patients (mean age: 45.2 y, ra nge: 31 to 75 y) with histologically proven locally advanced cervical cance r who were scheduled for preoperative chemoradiation were evaluated by TCD prior to beginning the treatment protocol. Tumor volume, number of vessels within the tumor, lowest resistance index (RI), maximum peak systolic veloc ity (PSV), and the ratio between the number of vessels and tumor volume (tu mor vascular density, TVD) were calculated. All patients underwent preopera tive chemoradiation and radical surgery. Complete pathological response (pa thCR) was considered: when no residual tumor was found on surgical specimen s, Partial pathological response (pathPR) was considered when residual tumo r was found. PathCR was achieved in three patients (30%), whereas 7 (70%) h ad pathPR. Mean tumoral volume was not statistically different between thos e with pathCR (33.2 cm(3)) and those with pathPR (20.3 cm(3)) (p = 0.305), Those tumors with pathCR had lower mean number of vessels ( 3.3 us. 5.3, p = 0.01), lower TVD (0.1 vs. 1.1, p = 0.05) and higher RI (0.41 vs. 0.29, p = 0.03). No differences were found in PSV,. Although these data are prelimi nary, our results suggest that TCD may be used to predict pathological resp onse to preoperative chemoradiation in patients with locally advanced cervi cal cancer. (C) 1999 World Federation for Ultrasound in Medicine & Biology.