Significance of computed tomography‐measured volume in the prognosis of cervical carcinoma

Abstract

Background. Computed tomography (CT) can visualize the volume and shapes of the deep‐seated tumors and is expected to predict the treatment outcome in a more quantitative manner. This study was undertaken to learn the prognostic significance of CT‐provided information in the radiation therapy of carcinoma of the cervix. Methods. One hundred thirty‐one CT evaluations were systematically applied to 87 patients having carcinoma of the cervix uteri. The cervical mass volume was measured by CT at a certain phase or phases of treatment and was analyzed in relation to their local control at 3 years and the survival at 5 years. Results. The initial volume, measured at the beginning of radiation therapy, was not a significant prognostic guide for the local control. However, the second volume, the volume of cervical lesion measured immediately after the completion of external irradiation, proved to be a prominent prognostic factor for both the 3‐year local control and 5‐year survival, regardless of the clinical stage. In 52 patients whose second volume was less than 38 cm3, 47 patients (90.4%) were locally controlled for 3 years or more after radiation therapy, whereas 17 of 23 patients (73.9%) whose second volume exceeded 38 cm3 failed in the local control. Five‐year actuarial survival rate was 53.1% plus or minus 6.2% in the former group and 26.1% plus or minus 9.6% in the latter group. Conclusions. CT‐aided volumetry provides for an early prediction of treatment failure in radiation therapy for cervical carcinoma. Copyright © 1993 American Cancer Society