Gynecology & Obstetrics
Open Access

Neoadjuvant chemotherapy of locally advanced cervical cancer - Ultrasound monitoring and further surgical intervention

2^nd International Congress on Contemporary Issues in Women Cancers & Gynecologic Oncology

August 29-30, 2017 | London, UK

S L Vashakmadze, O I Alyoshikova, S V Ivashina, T A Motskobili and L A Ashrafyan

Russian Scientific Center of Roentgenoradiology, Russia
Research Center of Obstetrics, Gynecology and Perinatology named after V I Kulakov, Russia

Posters & Accepted Abstracts: Gynecol Obstet (Sunnyvale)

Abstract :

The accumulated material from 126 patients with locally advanced cervical cancer (LACC) receiving neoadjuvant chemotherapy (NACT) allows us to outline ways of solving the problem of monitoring the first step of treatment aimed at identifying groups of patients who can undergo radical surgical intervention on the second step. We have set clear parameters of NACT efficacy (2 courses under the TP scheme) by modern sonography aimed at studying the changes in tumor volume, angioarchitectonics and velocity indices of blood flow in the uterine arteries and vessels of the cervical tumor. We developed a working classification of vascular network of cervi�?al tumor, indicating the severity of NACT effect and determined ultrasound signs of LACC resectability (115 of 126 patients underwent operation). We conducted correlation analysis where high diagnostic value of ultrasound in NACT is not inferior to MRI and compared the parameters of Doppler ultrasound with drug pathomorphosis, where established high correlation. We found that the dynamics of SCC marker level should be considered only in conjunction with more objective ultrasound parameters but not as an independent criterion of NACT efficiency. We revealed that the decrease in cervical volume according to 3D sonography more than 30% after 1 and 50% after 2 courses indicates high sensitivity of tumor to NACT. Radical surgical intervention on the second step is feasible when tumor volume after two courses reduced by more than 50% but not exceeding 50 cm3. For the objective solving the problem of NACT efficiency in LACC requires the use of modern sonography.