Correlation of Tumor Vascularization Using Spectral Pulse Wave Doppler with Neoadjuvant Chemotherapy Response in IB2 and IIA2 stages of Cervical Cancer

Syamel Muhammad(1*), Nindya Rahmadita(2)

(1) Sub Division of Gynecological Oncology, Obstetrics and Gynecology Department, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang
(2) Medical Student, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang
(*) Corresponding Author



Cervical cancer is an abnormal growth or cell changes in the cervical wall, which is the 4th rank in the most common cancer among female and the 2nd most common cancer in female aged fifteen until fourty four years old worldwide. Neovascularization becomes an important step in determining the onset and progressive cancer. Neoadjuvant chemotherapy has been evaluated as a treatment strategy in the stages IB2 and IIA2. The use of chemotherapy drug becomes more effective in adjacent and regular vascularization, and it allows the blood flow to the organs more quickly. This study aims to determine the correlation of tumor vascularization using Spectral Pulse Wave Doppler with neoadjuvant chemotherapy response in IB2 and IIA2 stages of cervical cancer. This research is a cohort analytic study which involves thirty six of patient in IB2 and IIA2 stages. The sampling is selected by using consecutive sampling technique. The data includes the result of ultrasound examination and were analyzed by using the Chi-square test. The results of the research on good and poor tumor vascularization had a good response to thirty of patient (83.3%) who were given neoadjuvant chemotherapy. There was no significant effect between tumor vascularization using Spectral Pulse Wave Doppler to the responses of neoadjuvant chemotherapy in IB2 and IIA2 stages of cervical cancer.

Keywords: tumor vascularization using Spectral Pulse Wave Doppler, responses of neoadjuvant chemotherapy, IB2 and IIA2 stages of cervical cancer

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Bruni L, Barrionuevo-Rosas L, Alberto G, Serrano B, Mena M, Gómez D, et al. Human Papillomavirus and Related Diseases Report. ICO/IARC HPV Information Centre; 2017.

Kementrian Kesehatan RI. Situasi Penyakit Kanker. Riset Kesehatan Dasar. 2015.

Yanti YN. Gambaran Faktor Resiko Kejadian Kanker Serviks di RSUP Dr. M. Djamil Padang. Jurnal Kesehatan Andalas. 2018;3(1):1–17.

Deverakonda A, Gupta N. Diagnosis and treatment of cervical cancer: a review. J Nurs Heal Sci. 2016;2(3):1–11.

Marth C, Landoni F, Mahner S, McCormack M, Gonzalez-Martin A, Colombo N. Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(4):72–83.

Lapresa M, Parma G, Portuesi R, Colombo N. Neoadjuvant chemotherapy in cervical cancer: An update. Expert Rev Anticancer Ther. 2015;15(10):1171–81.

González-Martín A, González-Cortijo L, Carballo N, Garcia JF, Lapuente F, Rojo A, et al. The current role of neoadjuvant chemotherapy in the management of cervical carcinoma. Gynecol Oncol. 2008;110:36–40.

Sardi JE, Giaroli A, Sananes C, Ferreira M, Soderini A, Bermudez A, et al. Long-Term Follow-up of the First Randomized Trial Using Neoadjuvant Chemotherapy in Stage Ib Squamous Carcinoma of the Cervix : The Final Results. Gynecol Oncol. 1997;67:61–9.

Loizzi V, Vecchio V Del, Crupano FM, Minicucci V, Fumarulo V V, Resta L, et al. A phase II study : dose-dense carboplatin and paclitaxel as neoadjuvant chemotherapy in locally advanced cervical cancer A phase II study : dose-dense carboplatin and paclitaxel as neoadjuvant chemotherapy in locally advanced cervical cancer. J Chemother. 2018;30(4):247–52.

Iwata T, Miyauchi A, Suga Y, Nishio H, Nakamura M, Ohno A, et al. Neoadjuvant chemotherapy for locally advanced cervical cancer. Chinese J Cancer Res. 2016;28(2):235–40.

Alldredge JK, Tewari KS. Clinical Trials of Antiangiogenesis Therapy in Recurrent/Persistent and Metastatic Cervical Cancer. Oncologist. 2016;21(5):576–85.

Mangla M, Singla D. Transvaginal colour Doppler ultrasound in predicting response to chemoradiation in patients with carcinoma of the cervix. South African J Gynaecol Oncol. 2015;7(2):68–71.

Belitsos P, Papoutsis D, Rodolakis A, Mesogitis S, Antsaklis A. Three-dimensional power Doppler ultrasound for the study of cervical cancer and precancerous lesions. Ultrasound Obstet Gynecol. 2012;40(5):576–81.

Onofrio AD, Gandolfi A. Chemotherapy of vascularised tumours: Role of vessel density and the effect of vascular ”pruning”. J Theor Biol. 2010;264(2):253.

Dahlan MS. Besar Sampel dan Cara Pengambilan Sampel dalam Penelitian Kedokteran dan Kesehatan. Edisi 3. Vol. 3, Salemba Medika. 2010. 46-60 p.

Qin J, Cheng X, Chen X, Zhang X, Lu W, Xie X. Value of three-dimensional power Doppler to predict clinical and histological response to neoadjuvant chemotherapy in locally advanced cervical carcinoma. Ultrasound Obs Gynecol. 2012;39(1):226–34.

Testa AC, Ferrandina G, Distefano M, Fruscella E, Mansueto D, Basso D, et al. Color Doppler velocimetry and three-dimensional color power angiography of cervical carcinoma. Ultrasound Obstet Gynecol. 2004;24(4):445–52.

Dodampahala SH, Jayakody SN, Gunathilake WCC, Rahubaddha AN, Dodampahala SK. Transvaginal Color Doppler in the Assessment of Cervical Carcinoma and Pre-Cancer : Evidence from a Case Control Study Using Colour Doppler Ultrasonography Pulsatility Index of Uterine Vasculature. Sci Res Publ. 2016;4(3):93–9.

Muhammad S, Suardi D, Tobing MDL. Hubungan gambaran spektral pulse wave doppler dengan respon klinis terapi radiasi eksternal pada kanker serviks stadium IIB-IVA. Maj Kedokt Andalas. 2018;41(1):10–21.

Greco P, Cormio G, Vimercati A, Nacci G, Vagno G Di, Loverro G, et al. Transvarrinal color Doppler ultrasound for monitoring the response to neoadjuvant chemotherapy in advanced cervical cancer. Acta Obstet Gynecol Scand. 1997;76(2):169–72.

Zhu P, Ou Y, Dong Y, Xu P, Yuan L. Expression of VEGF and HIF-1α in locally advanced cervical cancer: potential biomarkers for predicting preoperative radiochemotherapy sensitivity and prognosis. Onco Targets Ther. 2016;9:3031–7.

Chen C-A, Cheng W-F, Lee C-N, Su Y-N, Hsieh C-Y, Hsieh F-J. Power Doppler vascularity index for predicting the response of neoadjuvant chemotherapy in cervical carcinoma. Acta Obstet Gynecol Scand. 2004;83:591–7.

Couvreur K, Naert E, Jaeghere E De, Tummers P, Makar A, Visschere P De, et al. Neo-adjuvant treatment of adenocarcinoma and squamous cell carcinoma of the cervix results in significantly different pathological complete response rates. 2018;1–10.

Nishida N, Yano H, Nishida T, Kamura T, Kojiro M. Angiogenesis in cancer. Vasc Health Risk Manag. 2006;2(3):213–9.

Santoso C, Askandar B. Keberhasilan Kemoterapi Neoajuvan Cisplatin-Vincristine-Bleomycin dan Paclitaxel-. Maj Obstet Ginekol. 2011;19(3):1–11.

Fischetti M, Musella A, Di V, Giorgia D. Dose-Dense Neoadjuvant Chemotherapy plus Radical Surgery in Locally Advanced Cervical Cancer : A Phase II Study. 2015;103–10.


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