80 Intratumoral P02 measurements as predictive assay in the treatment of primary cervical cancer

Oxygenation Status of Cervical Carcinomas Before and During Spinal Anesthesia for Application of Brachytherapy

“…In 1994, pO 2 histography became included into the clinical routine in patients with cervical carcinomas at our department [23,33]. Until now, the pO 2 measurements in cervical carcinomas have been performed without spinal anesthesia in order to avoid any influence of the anesthesiologic management.…”

“…One patient with stage IB tumor had previously undergone incomplete conization and refused hysterectomy. According to our treatment protocol [23,33], a combined treatment with brachytherapy and external-beam therapy was planned for all patients. The patients received high-dose-rate (HDR) brachytherapy with weekly applications of 7 Gy per fraction in point A [23,33,39].…”

“…Preparation and calibration of the pO 2 measuring device were performed as described earlier [23]. A reference pO 2 measurement in pubic subcutaneous tissue was performed and the vaginal temperature measured.…”

“…To provide a guiding structure for the electrode tracks, two thin catheters were introduced into the macroscopically visible tumor in the cervix (6-o'clock and 12-o'clock position). The electrode was moved parallel to the cervical canal, and intratumoral pO 2 measurements were performed along these tracks [23].…”

“…In the treatment of carcinoma of the uterine cervix by both irradiation and surgery, tumors with a poorer oxygenation or a larger hypoxic fraction have a worse treatment outcome, and both the local control and rate of distant metastases are influenced by the oxygenation status [12,14,15,21,23,43].…”