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Prognostic significance of tumor volume as determined on 3D ultrasound scan in uterine cervix cancer treated by radiotherapy

1 Department of Radiotherapy and Oncology, J. K. Cancer Institute, Kanpur, Uttar Pradesh, India
2 Radiodiagnosis, J. K. Cancer Institute, Kanpur, Uttar Pradesh, India

Correspondence Address:
Surendra Kumar Saini,
Department of Radiotherapy and Oncology, M. P. Shah Government Medical College, Jamnagar - 361 008, Gujarat
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Source of Support: None, Conflict of Interest: None

Aims: The aim of this prospective study is to evaluate prognostic significance of tumor volume determined by three-dimensional (3D) ultrasound scan in uterine cervix cancer patients treated by radiotherapy. Patients and Methods: A total of 67 patients of Stage IB2-IIIB were studied and analyzed. Cervical tumor volume was determined by 3D ultrasound scan. Two groups were made on the basis of volume on ultrasound scan (Group 1 <40 cc = 36 and Group 2 >40 cc = 31). Both groups received external beam radiotherapy (EBRT) and intracavitary radiation therapy (ICRT). Cisplatin 40 mg/m 2 every week was given concurrently with external irradiation. Tumor volumes were taken by 3D USG every week during EBRT, after each fraction of ICRT, and after 8 weeks of completion of treatment. Primary end point was disease-free survival (DFS), and secondary endpoints were 5-year survival and toxicities. Results: After 2 months of completion of treatment, 1 out of 36 patients of Group A was having residual and 7 out of 31 of Group B were having residual diseases (P = 0.034). DFS and 5-year survival were significantly different in the groups (log rank test P = 0.0014, hazard ratio (HR) =2.3622 95% confidence interval (CI) 1.3090–4.2625 and P = 0.0421, HR = 1.9274 95% CI 0.9998–3.7156, respectively). Conclusions: Ultrasound is a cheap, simple, and useful in predicting the outcome of treatment and DFS based on the tumor volume.

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