Echographic evaluation of uterine cervix cancer before and after chemotherapy

Objective: To evaluate if echographic and Doppler scans help to access and predict uterine cervix cancer clinical response to chemotherapy. Methods: Using transvaginal ultrasound and Doppler, we scanned 22 uterine cervix epidermöid carcinoma patients, clinical stage II and III before and after three cycles of adjuvant chemotherapy (cisplatin and ifosfamide). Results: Five patients presented complete response (CR), 12 partial response (PR), and five did not respond (NR). Fourteen of the responsive (R) patients were submitted to radical hysterectomy. Before chemo, the main blood inflow was central and abundant in all NR patients. Hydronephrosis was detected by echography after chemo in 3/5 of the NR group while it occurred in one patient in the R group. We found chemotherapy to be effective in reducing uterine and cervix volumes. Chemotherapy induced a significant shrinkage of the uterine cervix in both CR and PR subsets. Although PI and RI did not change under chemotherapy for both R and NR groups, PI and RI from the uterine artery revealed significant differences between CR and PR patients at the time of the initial scan (p=0,01). Conclusion: We found echography an excellent guide tool to follow up tumors of the uterine cervix submitted to chemotherapy