Locally Advanced Squamous Cell Carcinoma of the Uterine Cervix: MR Evaluation of Effect of Combined Biologic (13-cis-Retinoic Acid plus Interferon alpha-2a) and Radiation Therapy

ABSTRACT

PURPOSE: To evaluate the effectiveness of MR imaging in assessing the response of carcinomas of the uterinecervix to the combined therapy of interferon alpha-2a, 13-cis-retinoic acid and radiation. MATERIALS AND METHODS: Thirteen patients with untreated, locally advanced squamous cell cervical carcinoma were treated for eight weeks with 13-cis-retinoic acid plus interferon alpha-2a and radiotherapy. Axial and sagittal T1-weighted spin echo and fast spin echo MR images were obtained before and after treatment, using a 1.5-T MR scanner. MR images were correlated with biopsy findings. In each patient, pre- and post-treatment images were prospectively analyzed andcompared. RESULTS: In all patients, tumor volume could be calculated by three dimensional measurement on MR images. Initial response to the combined therapy was complete in eight patients, partial in four and progressivein one. Evidence of tumor recurrence was noted in two patients during the follow-up period. MR images correlated well with biopsy findings. CONCLUSION: MR imaging is useful in the evaluation of tumor response to the combined biologic and radiation therapy, which can be an effective first-line therapy against locally advanced squamouscell carcinoma of the cervix.