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Purpose <p>To evaluate serial tumour volume regression patterns in cervical cancer patients undergoing definitive chemoradiotherapy, using ultrasound as a feasible and low-cost imaging modality for response assessment in resource-limited settings.</p> Materials and Methods <p>This retrospective study included sixty seven patients with histologically confirmed cervical cancer treated between 2010 and 2012. All patients received external beam radiotherapy (EBRT) to the pelvis followed by high-dose-rate intracavitary brachytherapy (ICRT). Transabdominal ultrasound was used to measure tumour volume at baseline (pre-treatment), after 5, 10, 15, 20, and 25 fractions of EBRT, and after each of three ICRT applications. Tumour volumes were calculated using the ellipsoid formula. Volume regression percentages were calculated relative to baseline, and trends were analysed using descriptive statistics, line plots, boxplots, and correlation heatmaps.</p> Results <p>Tumour volume decreased consistently across all treatment phases. By the end of EBRT, median volume reduction was approximately 40%, with further reductions exceeding 80% after the third ICRT in most patients. Individual patient trends showed variability in response kinetics, but strong correlations were observed between early and late tumour regression. Heatmap analysis revealed predictive associations between early response (after 10–15 fractions) and final residual volume. Ultrasound was feasible and reproducible across all serial assessments.</p> Conclusions <p>Ultrasound-based volumetric monitoring is a practical and effective method for tracking tumour regression in cervical cancer. It enables real-time evaluation of treatment response and supports the integration of adaptive radiotherapy strategies, particularly in settings where MRI is not routinely available.</p>

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Serial Tumour Volume Reduction During Chemoradiotherapy in Cervical Cancer: Insights from Ultrasound-Based Monitoring in a Resource-Constrained Setting

  • 期刊论文

  • 发表日期：

    2026年2月25日

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  • Shelly Srivastava,
  • Surendra Kumar Saini

摘要

Purpose

To evaluate serial tumour volume regression patterns in cervical cancer patients undergoing definitive chemoradiotherapy, using ultrasound as a feasible and low-cost imaging modality for response assessment in resource-limited settings.

Materials and Methods

This retrospective study included sixty seven patients with histologically confirmed cervical cancer treated between 2010 and 2012. All patients received external beam radiotherapy (EBRT) to the pelvis followed by high-dose-rate intracavitary brachytherapy (ICRT). Transabdominal ultrasound was used to measure tumour volume at baseline (pre-treatment), after 5, 10, 15, 20, and 25 fractions of EBRT, and after each of three ICRT applications. Tumour volumes were calculated using the ellipsoid formula. Volume regression percentages were calculated relative to baseline, and trends were analysed using descriptive statistics, line plots, boxplots, and correlation heatmaps.

Results

Tumour volume decreased consistently across all treatment phases. By the end of EBRT, median volume reduction was approximately 40%, with further reductions exceeding 80% after the third ICRT in most patients. Individual patient trends showed variability in response kinetics, but strong correlations were observed between early and late tumour regression. Heatmap analysis revealed predictive associations between early response (after 10–15 fractions) and final residual volume. Ultrasound was feasible and reproducible across all serial assessments.

Conclusions

Ultrasound-based volumetric monitoring is a practical and effective method for tracking tumour regression in cervical cancer. It enables real-time evaluation of treatment response and supports the integration of adaptive radiotherapy strategies, particularly in settings where MRI is not routinely available.