Effect of Chemotherapy on Vascularization of Cervical Cancer

Standard chemotherapy suppresses angiogenesis and reduces vascularization of cervical cancer (CC). A more pronounced response to treatment was detected in more vascularized and oxygenated tumors, but it follows that suppression of angiogenesis during initial courses of chemotherapy may lead to a decrease in the response after subsequent treatment. Preservation of the numerical vessel density during therapy can serve as a prognostic factor for an insufficiently good response to treatment. Methods of molecular targeted therapy of CC are aimed primarily at inhibiting angiogenesis and restoring the normal functioning of the immune system fighting the tumor. The addition of targeted antiangiogenic therapy drugs to standard cytostaticagents for the treatment of patients with persistent, recurrent, or metastatic CC increases progression-free survival and overall life expectancy, but the side effects of such therapy are often severe and sometimes fatal. The main complications recorded are neutropenia, central and peripheral arterial and venous thrombosis, the formation of intestinal and vaginal fistulas. Resistance to targeted drugs develops very quickly, followed by restoration and even an increase in vascularization due to the progression of tumor cell hypoxia and the inclusion of angiogenesis pathways without the VEGF participation. It should be noted that suppression of angiogenesis during any method of treating cervical cancer increases hypoxia of the remaining tumor, which contributes to increased production and release of proangiogenic cytokines, such as VEGF, and the progression of angiogenesis.

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