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 to cite this document:

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

DOI to cite this document:

10.5283/epub.56307 Copy

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

License: Creative Commons Attribution 4.0 PDF - Published Version (701kB)

Date of publication of this fulltext: 29 Feb 2024 12:27

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Details

Item type:	Article
Open Access Type:	DEAL (Springer) - Non UR
Journal or Publication Title:	Strahlentherapie und Onkologie
Publisher:	Springer
Place of Publication:	HEIDELBERG
Volume:	197
Number of Issue or Book Chapter:	6
Page Range:	pp. 520-527
Date:	3 May 2021
Institutions:	Medicine > Lehrstuhl für Röntgendiagnostik
Identification Number:	Value Type 10.1007/s00066-021-01782-5 DOI
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 Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	56307

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Abstract

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 ...

Abstract

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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Metadata last modified: 25 Apr 2024 09:28

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