PuSH - Publikationsserver des Helmholtz Zentrums München: Correlations of UICC tumor stage and tumor regression on T2-weighted MRI sequences during definitive radiotherapy of cervical cancer.

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Arend, F.* ; Oechsner, M.* ; Weidenbächer, C.B.* ; Combs, S.E. ; Borm, K.J.* ; Duma, M.N.*

Correlations of UICC tumor stage and tumor regression on T2-weighted MRI sequences during definitive radiotherapy of cervical cancer.

Tumori 107, 139-144 (2020)

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Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.

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Background: The purpose of this study is to detect a correlation between the preradiation tumor staging and the relative volumetric regression of the primary tumor through external beam radiation therapy (EBRT). Methods: Clinical data of 32 patients with a mean age of 60 +/- 12 years treated with primary radiation therapy (RT) of cervical carcinoma were analyzed. Union Internationale Contre le Cancer (UICC) stages were T1 = 4 patients, T2 = 15 patients, T3 = 8 patients, T4 = 5 patients; N1 = 26 patients, N0 = 6 patients; and M0 = 25 patients, M1 = 7 patients. All patients received pelvic magnetic resonance imaging (MRI) before RT as well as during RT. The cervical primary tumor was delineated as gross tumor volume (ptGTV) in T2-weighted MRI sequences. We compared ptGTV reduction by stage, lymph node status, metastatic status, and grading. Results: Mean ptGTV reduction during RT was 61.4 +/- 28.9%. T1 tumors shrank by 88.2 +/- 13.4%, T2 by 67.6 +/- 28.7%, T3 by 50.8 +/- 23.6%, and T4 by 38.7 +/- 27.2%. The difference in tumor shrinkage was statistically significant between the lower T stages and the higher T stages (p< 0.05). There was no statistical difference in the mean ptGTV before treatment in the group with lymph node metastases (LNM) (54.1 +/- 47.7 cm(3)) as compared to the group without LNM (76.6 +/- 52.2 cm(3)). Nonetheless, ptGTV shrank significantly differently: by 68.9 +/- 25.7% (N1 patients) and by 29.0 +/- 17.7% (N0 patients). No significant differences in ptGTV shrinkage were observed in M0 versus M1 and G2 versus G3 tumors. Conclusion: There is a correlation between mean ptGTV reduction during EBRT and tumor stages. Tumors with higher T stages shrank less under radiation treatment, and the ptGTV of N1 patients responded better than that of N0 patients.

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