Conventional 3D conformal radiotherapy and volumetric modulated arc therapy for cervical cancer: Comparison of clinical results with special consideration of the influence of patient- and treatment-related parameters

URN zum Zitieren dieses Dokuments:

urn:nbn:de:bvb:355-epub-563076 Copy

DOI zum Zitieren dieses Dokuments:

10.5283/epub.56307 Copy

Dröge, Leif Hendrik ; von Sivers, Franziska-Felicitas ; Schirmer, Markus Anton ; Wolff, Hendrik Andreas

Lizenz: Creative Commons Namensnennung 4.0 International PDF - Veröffentlichte Version (701kB)

Veröffentlichungsdatum dieses Volltextes: 29 Feb 2024 12:27

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Alternative Links zum Volltext:DOIVerlag

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Details

Dokumentenart:	Artikel
Open Access Art:	DEAL (Springer) - Nicht UR
Titel eines Journals oder einer Zeitschrift:	Strahlentherapie und Onkologie
Verlag:	Springer
Ort der Veröffentlichung:	HEIDELBERG
Band:	197
Nummer des Zeitschriftenheftes oder des Kapitels:	6
Seitenbereich:	S. 520-527
Datum:	3 Mai 2021
Institutionen:	Medizin > Lehrstuhl für Röntgendiagnostik
Sonstige Projekte:	Projekt DEAL
Identifikationsnummer:	Wert Typ 10.1007/s00066-021-01782-5 DOI
Stichwörter / Keywords:	PELVIC RADIOTHERAPY; ENDOMETRIAL CANCER; TARGET VOLUME; CONSENSUS GUIDELINES; FIXED FIELD; TOXICITY; CARCINOMA; OUTCOMES; IMRT; DELINEATION; Gynecologic cancer; Radiochemotherapy; Intensity-modulated radiotherapy; Urinary toxicity; Small bowel toxicity; Body mass index
Dewey-Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
Status:	Veröffentlicht
Begutachtet:	Ja, diese Version wurde begutachtet
An der Universität Regensburg entstanden:	Ja
Dokumenten-ID:	56307

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Zusammenfassung

Purpose Intensity-modulated radiotherapy (IMRT) for cervical cancer yields favorable results in terms of oncological outcomes, acute toxicity, and late toxicity. Limited data are available on clinical results with volumetric modulated arc therapy (VMAT). This study's purpose is to compare outcome and toxicity with VMAT to conventional 3D conformal radiotherapy (3DCRT), giving special ...

Zusammenfassung

Purpose Intensity-modulated radiotherapy (IMRT) for cervical cancer yields favorable results in terms of oncological outcomes, acute toxicity, and late toxicity. Limited data are available on clinical results with volumetric modulated arc therapy (VMAT). This study's purpose is to compare outcome and toxicity with VMAT to conventional 3D conformal radiotherapy (3DCRT), giving special consideration to the influence of patient- and treatment-related parameters on side effects. Materials and methods Patients with cervical cancer stage I-IVA underwent radiotherapy alone or chemoradiotherapy using 3DCRT (n = 75) or VMAT (n = 30). Survival endpoints were overall survival, progression-free survival, and locoregional control. The National Cancer Institute Common Terminology Criteria for Adverse Events and the Late Effects of Normal Tissues criteria were used for toxicity assessment. Toxicity and patient- and treatment-related parameters were included in a multivariable model. Results There were no differences in survival rates between treatment groups. VMAT significantly reduced late small bowel toxicity (OR = 0.10, p = 0.03). Additionally, VMAT was associated with an increased risk of acute urinary toxicity (OR = 2.94, p = 0.01). A low body mass index (BMI; OR = 2.46, p = 0.03) and overall acute toxicity >= grade 2 (OR = 4.17, p < 0.01) were associated with increased overall late toxicity. Conclusion We demonstrated significant reduction of late small bowel toxicity with VMAT treatment, an improvement in long-term morbidity is conceivable. VMAT-treated patients experienced acute urinary toxicity more frequently. Further analysis of patient- and treatment-related parameters indicates that the close monitoring of patients with low BMI and of patients who experienced relevant acute toxicity during follow-up care could improve late toxicity profiles.

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