Effect of intraarterial and systemic chemotherapy for stage IIb cervical carcinoma: assessment of therapeutic response using MR imaging

To evaluate the effectiveness of intraarterial chemotherapy(IAC) and systemic chemotherapy(SC) in cases of locally advanced cervical carcinoma, and to assess the accuracy of magnetic resonance(MR) imaging for determining parametrial invasion after IAC or SC. Among 44 patients with stage IIb cervical carcinoma, IAC was performed in 25 and SC in 19. MR images obtained before and after IAC or SC were prospectively analyzed with regard to tumor volume and parametrial invasion, and tumor response to chemotherapy was classified as complete, partial, or progressive. Forty-one patients underwent radical hysterectomy within two weeks of the second MR examination, and postoperative pathologic findings were correlated with radiologic findings. The average reduction rate of tumor volume in the IAC and SC group was 89.2% and 66.3%, respectively. Between the two groups, there was no statistically significant difference(p>0.05). In the IAC group, 13 patients showed a complete response and 11 a partial response, and in one there was progression. In the SC group, eight patients showed a complete response and nine a partial response, and in two there was progression. The accuracy of MR imaging for determining parametrial invasion after chemotherapy was 87.8%. In each patient there was close correlation between MR imaging and pathologic findings. There was no statistically significant difference in tumor reduction between the IAC and SC group. After chemotherapy for stage IIb cervical carcinoma, MR imaging is a valuable modality for determining surgical candidates.=20