SEROLOGICAL MARKERS AND DOPPLER PARAMETERS IN THE ASSESSMENT OF THE EFFECTIVENESS OF RADIATION THERAPY FOR CERVICAL CANCER
Objective is to identify the dynamics of Doppler assessment of neovascularization and SCCA tumor marker in the course of radiation therapy for cervical cancer and to investigate the correlation between these values in cancer progression. Materials and Methods. A total of 112 patients with histologically verified invasive stage IIA-B and BIIIB cervical cancer aged 27 to 80 years (mean value was 47,5 ± 2,5 years). Based on certain types of tumor growth the patients were divided into 4 groups: group 1 (mixed type of cervical cancer) included 44 patients, group 2 (exophytic type of cervical cancer) - 14 patients, group 3 (endophytic type of cervical cancer) - 40 patients, group 4 (infiltrating, ulcerated type of cervical cancer) included 14 patients. Subgroups with a favorable and unfavorable course of disease after combined external beam irradiation and internal radiation therapy were identified in every group. All patients in pre-radiation, peri-radiation and post-radiation time periods were examined using comprehensive diagnostic ultrasound scanning with Doppler screening of cervical and intratumoral vessels. Dynamic monitoring of tissue Doppler imaging parameters of resistive index (RI), pulsatility index (PI), peak systolic velocity (PSV) and the results of SCCA tumor markers was carried out in establishing diagnosis, during combined external beam irradiation and internal radiation therapy and after the treatment. Results. Analysis of the results of Doppler ultrasound revealed that significant changes in resistive index (RI) occur only one month after treatment. In unfavorable course of disease resistive index (RI) ranged from 0,36 to 0,45, that is considerably lower compared to the values determined in the groups with favorable outcome. The Pearson correlation coefficient, based on variables with interval and nominal scale, was calculated for average values of resistive index (IR) and SCCA in each of four clinical groups for the subgroups with favorable and unfavorable course of disease. In the study groups in which the course of disease was favorable high values of negative correlation were observed: the Pearson coefficient ranged from - 0,9115 to - 0,9820. In the groups with unfavorable course of cervical cancer Pearson coefficient was in-homogeneous -from - 0,6545 to - 0,9262. Conclusions. The high degree of negative correlation between the values of resistive index (RI) of intratumoral blood flow and tumor marker SCCA was determined in patients with cervical cancer of different types of tumor growth during treatment based on the disease course.