Serviks Kanserinde Prognostik Kriterlerin Tedavi Sonrası Erken Radyolojik Cevaba Etkisi

Amaç: Serviks kanseri tanısıyla kliniğimizde tedavi uygulanan hastalarda bilinen prognostik faktörlerin, erken dönem radyolojik tümör yanıtı ile olan ilişkisini belirlemek amaçlandı. Gereç-Yöntem: Kliniğimizde definitif radyoterapi ve eş zamanlı kemoterapi uygulanan 26 hastanın eksternal pelvik radyoterapi ve brakiterapi öncesi ve sonrasında çekilen manyetik rezonans (MR) ve pozitron emisyon tomografisi-bilgisayarlı tomografi (PET-CT) tetkikleri ile gözlenen radyolojik klinik cevabın/tümör yanıtının prognostik kriterler ile ilişkisi retrospektif olarak değerlendirildi. Bulgular: Tedavi öncesi ve sonrası MR ve PET-CT tetkiklerindeki tümör çapı ve SUVmax değeri ölçüm yüzde farkları karşılaştırıldığında; MR’da % 50’nin altında yanıt alınanlarda sigara varlığı (p=0,07) ve başlangıç tümör çapının 2 cm’nin üzerinde olması (p=0,01) ile istatistiksel anlamlı ilişki mevcuttu. PET-CT’de ise SUVmax değişim oranı % 50’nin altında yanıtlı hastalarda skuamoz hücreli karsinom dışı histoloji (p=0,03) ve mesane invazyonu varlığı (p=0,06) açısından istatistiksel açıdan anlamlı bir ilişki saptandı. Sonuç: Serviks kanserinde bilinen prognostik kriterlerden bazıları tedaviye bağlı erken dönem tümör cevabı ile ilişkili olabilir.

Anahtar Kelimeler:

serviks kanseri, prognostik krterler, radyolojik cevap, radyoterapi

The Effect of Prognostic Criteria on the Early Radiological Response After Radiotherapy in Cervical Cancer

Objective: The aim of this study was to determine the relationship between known prognostic factors and early radiological tumor response in patients with cervical cancer.Methods: In our clinic, magnetic resonance (MR) and positron emission tomography-computed tomography (PET-CT) were performed before and after external pelvic radiotherapy and brachytherapy to 26 patients who performed definitive radiotherapy and concurrent chemotherapy. The relationship of radiological clinical response / tumor response with prognostic criteria was evaluated retrospectively.Results: When the measurement percentage differences between tumor diameter and SUVmax value were compared in pre- and post-treatment MR and PET-CT tests; there was a statistically significant correlation between the presence of cigarette smoking (p = 0.07) and initial tumor diameter over 2 cm (p = 0.01) in patients with MR responses are under 50%. In PET-CT, there was a statistically significant relationship in patients with SUVmax change rate less than 50%, in terms of squamous cell carcinoma histology (p = 0.03) and bladder invasion (p = 0.06). Conclusion: Some of the known prognostic criteria in cervical cancer may be associated with early term tumor response to treatment.

Keywords:

Cervical cancer, prognostic criteria, radiological response, radiotherapy,

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