Purpose: to determine preoperative SPECT-CT localization of sentinel lymph nodes (SLN) in women with cervical cancer.
Materials and methods: SPECT-CT visualization of SLN was performed in 44 women with clinical stage IB-IIB cervical cancer. SPECT-CT examinations started 120-240 min after peritumoural injections of 99mTc-radiocolloids (200-300MBq in 0.4-1ml). All visualized LNs with uptake of radiocolloids were regarded as SLN. In all women we determined topography of SLN and lymph-flow patterns.
Results: SLN were successfully visualized in 93.1% cases (41/44 women). The bilateral pattern of lymph flow was mentioned in 26 (63.4%), monolateral - in 15 (36.5%) cases. SLN localized in external iliac region in 25 (60.9%), internal iliac - in 14 (34.1%), obturator - in 22 (53.6%), presacral - in 1 (2.4%), common iliac region - in 21 (53,8%) cases. Uptake of radiocolloids in paraaortal lymph nodes was mentioned in 14 (34.1%) women
Conclusion: SPECT-CT visualization of SLN can give important information for surgery and radiotherapy planning.
In 24 patients (mean age 48 years) with locally advanced cervical cancer there were studied the efficacy and toxicity of 3 cycles of neoadjuvant dose-intensive chemotherapy with cisplatin (75 mg/m2) and doxorubicin (35 mg/m2) administered intravenously on the first day of a two- week cycle with the support of colony-stimulating factors. An important criterion for the inclusion in this study of patients with locally advanced cervical cancer (T1b2-2bN0-1M0) was the absence of infiltration of the anterior parameters according to the gynecological examination and MRI studies. An objective response to treatment was registered in 72.7 % of cases. Progression of the disease was not detected in any case. Conducting neoadjuvant drug therapy allowed performing radical surgical intervention in 95.4 % of patients. The pathomorphlogical response of tumor of varying severity was 40.9 %. In 9.1 % complete clinical regression of tumor was confirmed by a complete pathomor-phological response (CR). The dose-intensive regimen of chemotherapy did not lead to a significant increase of complications on the drug and surgical stages. An analysis showed that dose-intensive neoadjuvant chemotherapy is a highly effective method in treatment for locally advanced cervical cancer.
On the basis of the Departments of Oncogynecology and Radiology of the N.N. Petrov Research Institute of Oncology there was performed a comparative analysis of the results of detection of the sentinel lymph node using a fluorescent method with Indocyanine Green (ICG) and a radioisotope method with 99m-labeled colloidal radiopharmaceutical in endometrial cancer patients undergoing laparoscopic hysterectomy with lymphadenectomy from June 2016 to December 2016. The study included 19 patients with early endometrial cancer. Specificity and sensitivity of methods of radiation diagnostics (ultrasound and MRI) in the detection of metastatic involvement of pelvic lymph nodes are also presented.
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