Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future
Purpose: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.Methods and Materials: Of 1416 patients fr...
Ausführliche Beschreibung
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E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2021 |
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| Übergeordnetes Werk: |
Enthalten in: International journal of radiation oncology, biology, physics - Amsterdam [u.a.] : Elsevier Science, 1975, 112 |
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| Übergeordnetes Werk: |
volume:112 |
| DOI / URN: |
10.1016/j.ijrobp.2021.09.055 |
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ELV007332882 |
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| 245 | 1 | 0 | |a Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future |
| 264 | 1 | |c 2021 | |
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| 520 | |a Purpose: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.Methods and Materials: Of 1416 patients from the EMBRACE-I study, 1199 and 1002 were prospectively evaluated using physician-assessed (Common Terminology Criteria for Adverse Events [CTCAE]) and patient-reported (European Organization for Research and Treatment of Cancer [EORTC]) GI symptoms, respectively. CTCAE severe grade (grade [G] ≥3) events were pooled according to the location in the GI tract (anus/rectum, sigmoid, and colon/small bowel). CTCAE G ≥2 and EORTC “very much” and “quite a bit” plus ”very much” scores (≥ ”quite a bit”) were analyzed for individual symptoms with Cox regression. Logistic regression was used for persistent G ≥1 and EORTC ≥ “quite a bit” symptoms, defined if present in at least half of follow-ups.Results: The incidence of G ≥3 events was 2.8%, 1.8%, and 2.3% for G ≥3 anus/rectum, sigmoid, and colon/small bowel events, respectively. Among G ≥2 symptoms, diarrhea and flatulence were the most prevalent (8.5% and 9.9%, respectively). Among patient-related factors, baseline morbidity, increasing age, smoking status, and low body mass index were associated with GI symptoms to varying degrees. Among treatment-related factors, rectum D2cm3 and the International Commission on Radiation Units and Measurements recto-vaginal reference point (ICRU RV-RP) correlated with G ≥3 anus/rectum events and moderate/persistent diarrhea, proctitis, bleeding, abdominal cramps, and difficulty in bowel control. Bowel D2cm3 correlated with G ≥3 sigmoid and colon/small bowel events and moderate/persistent diarrhea and flatulence. For external beam radiation therapy (EBRT), prescription dose correlated with G ≥3 anus/rectum, diarrhea, and difficulty in bowel control. Patients with large lymph-node boost (V57Gy) were at higher risk for G ≥3 sigmoid events, moderate/persistent diarrhea, proctitis, and cramps.Conclusions: The analysis showed that both EBRT and image guided adaptive brachytherapy contribute to GI symptoms after locally advanced cervical cancer treatment. Rectum D2cm3, ICRU RV-RP , and bowel D2cm3 are risk factors for GI morbidity. The risk for various symptoms was lower with an EBRT prescription of 45 Gy than 50 Gy and increased with larger V57Gy. | ||
| 700 | 1 | |a Jensen, Nina B.K. |e verfasserin |4 aut | |
| 700 | 1 | |a Pötter, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Fokdal, Lars U. |e verfasserin |4 aut | |
| 700 | 1 | |a Chargari, Cyrus |e verfasserin |4 aut | |
| 700 | 1 | |a Lindegaard, Jacob C. |e verfasserin |4 aut | |
| 700 | 1 | |a Schmid, Maximilian P. |e verfasserin |4 aut | |
| 700 | 1 | |a Sturdza, Alina |e verfasserin |4 aut | |
| 700 | 1 | |a Jürgenliemk-Schulz, Ina M. |e verfasserin |4 aut | |
| 700 | 1 | |a Mahantshetty, Umesh |e verfasserin |4 aut | |
| 700 | 1 | |a Hoskin, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Segedin, Barbara |e verfasserin |4 aut | |
| 700 | 1 | |a Rai, Bhavana |e verfasserin |4 aut | |
| 700 | 1 | |a Bruheim, Kjersti |e verfasserin |4 aut | |
| 700 | 1 | |a Wiebe, Ericka |e verfasserin |4 aut | |
| 700 | 1 | |a Van der Steen-Banasik, Elzbieta |e verfasserin |4 aut | |
| 700 | 1 | |a Cooper, Rachel |e verfasserin |4 aut | |
| 700 | 1 | |a Van Limbergen, Erik |e verfasserin |4 aut | |
| 700 | 1 | |a Sundset, Marit |e verfasserin |4 aut | |
| 700 | 1 | |a Pieters, Bradley R. |e verfasserin |4 aut | |
| 700 | 1 | |a Lutgens, Ludy C.H.W. |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Li Tee |e verfasserin |4 aut | |
| 700 | 1 | |a Villafranca, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Smet, Stéphanie |e verfasserin |4 aut | |
| 700 | 1 | |a Jastaniyah, Noha |e verfasserin |4 aut | |
| 700 | 1 | |a Nout, Remi A. |e verfasserin |4 aut | |
| 700 | 1 | |a Kirisits, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Chopra, Supriya |e verfasserin |4 aut | |
| 700 | 1 | |a Kirchheiner, Kathrin |e verfasserin |4 aut | |
| 700 | 1 | |a Tanderup, Kari |e verfasserin |4 aut | |
| 700 | 1 | |a EMBRACE Collaborative Group |e verfasserin |4 aut | |
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10.1016/j.ijrobp.2021.09.055 doi (DE-627)ELV007332882 (ELSEVIER)S0360-3016(21)02915-1 DE-627 ger DE-627 rda eng 610 DE-600 44.64 bkl 44.81 bkl Spampinato, Sofia verfasserin (orcid)0000-0002-1953-7313 aut Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.Methods and Materials: Of 1416 patients from the EMBRACE-I study, 1199 and 1002 were prospectively evaluated using physician-assessed (Common Terminology Criteria for Adverse Events [CTCAE]) and patient-reported (European Organization for Research and Treatment of Cancer [EORTC]) GI symptoms, respectively. CTCAE severe grade (grade [G] ≥3) events were pooled according to the location in the GI tract (anus/rectum, sigmoid, and colon/small bowel). CTCAE G ≥2 and EORTC “very much” and “quite a bit” plus ”very much” scores (≥ ”quite a bit”) were analyzed for individual symptoms with Cox regression. Logistic regression was used for persistent G ≥1 and EORTC ≥ “quite a bit” symptoms, defined if present in at least half of follow-ups.Results: The incidence of G ≥3 events was 2.8%, 1.8%, and 2.3% for G ≥3 anus/rectum, sigmoid, and colon/small bowel events, respectively. Among G ≥2 symptoms, diarrhea and flatulence were the most prevalent (8.5% and 9.9%, respectively). Among patient-related factors, baseline morbidity, increasing age, smoking status, and low body mass index were associated with GI symptoms to varying degrees. Among treatment-related factors, rectum D2cm3 and the International Commission on Radiation Units and Measurements recto-vaginal reference point (ICRU RV-RP) correlated with G ≥3 anus/rectum events and moderate/persistent diarrhea, proctitis, bleeding, abdominal cramps, and difficulty in bowel control. Bowel D2cm3 correlated with G ≥3 sigmoid and colon/small bowel events and moderate/persistent diarrhea and flatulence. For external beam radiation therapy (EBRT), prescription dose correlated with G ≥3 anus/rectum, diarrhea, and difficulty in bowel control. Patients with large lymph-node boost (V57Gy) were at higher risk for G ≥3 sigmoid events, moderate/persistent diarrhea, proctitis, and cramps.Conclusions: The analysis showed that both EBRT and image guided adaptive brachytherapy contribute to GI symptoms after locally advanced cervical cancer treatment. Rectum D2cm3, ICRU RV-RP , and bowel D2cm3 are risk factors for GI morbidity. The risk for various symptoms was lower with an EBRT prescription of 45 Gy than 50 Gy and increased with larger V57Gy. Jensen, Nina B.K. verfasserin aut Pötter, Richard verfasserin aut Fokdal, Lars U. verfasserin aut Chargari, Cyrus verfasserin aut Lindegaard, Jacob C. verfasserin aut Schmid, Maximilian P. verfasserin aut Sturdza, Alina verfasserin aut Jürgenliemk-Schulz, Ina M. verfasserin aut Mahantshetty, Umesh verfasserin aut Hoskin, Peter verfasserin aut Segedin, Barbara verfasserin aut Rai, Bhavana verfasserin aut Bruheim, Kjersti verfasserin aut Wiebe, Ericka verfasserin aut Van der Steen-Banasik, Elzbieta verfasserin aut Cooper, Rachel verfasserin aut Van Limbergen, Erik verfasserin aut Sundset, Marit verfasserin aut Pieters, Bradley R. verfasserin aut Lutgens, Ludy C.H.W. verfasserin aut Tan, Li Tee verfasserin aut Villafranca, Elena verfasserin aut Smet, Stéphanie verfasserin aut Jastaniyah, Noha verfasserin aut Nout, Remi A. verfasserin aut Kirisits, Christian verfasserin aut Chopra, Supriya verfasserin aut Kirchheiner, Kathrin verfasserin aut Tanderup, Kari verfasserin aut EMBRACE Collaborative Group verfasserin aut Enthalten in International journal of radiation oncology, biology, physics Amsterdam [u.a.] : Elsevier Science, 1975 112 Online-Ressource (DE-627)306659662 (DE-600)1500486-7 (DE-576)081986319 1879-355X nnns volume:112 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_31 GBV_ILN_2011 44.64 Radiologie 44.81 Onkologie AR 112 |
| spelling |
10.1016/j.ijrobp.2021.09.055 doi (DE-627)ELV007332882 (ELSEVIER)S0360-3016(21)02915-1 DE-627 ger DE-627 rda eng 610 DE-600 44.64 bkl 44.81 bkl Spampinato, Sofia verfasserin (orcid)0000-0002-1953-7313 aut Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.Methods and Materials: Of 1416 patients from the EMBRACE-I study, 1199 and 1002 were prospectively evaluated using physician-assessed (Common Terminology Criteria for Adverse Events [CTCAE]) and patient-reported (European Organization for Research and Treatment of Cancer [EORTC]) GI symptoms, respectively. CTCAE severe grade (grade [G] ≥3) events were pooled according to the location in the GI tract (anus/rectum, sigmoid, and colon/small bowel). CTCAE G ≥2 and EORTC “very much” and “quite a bit” plus ”very much” scores (≥ ”quite a bit”) were analyzed for individual symptoms with Cox regression. Logistic regression was used for persistent G ≥1 and EORTC ≥ “quite a bit” symptoms, defined if present in at least half of follow-ups.Results: The incidence of G ≥3 events was 2.8%, 1.8%, and 2.3% for G ≥3 anus/rectum, sigmoid, and colon/small bowel events, respectively. Among G ≥2 symptoms, diarrhea and flatulence were the most prevalent (8.5% and 9.9%, respectively). Among patient-related factors, baseline morbidity, increasing age, smoking status, and low body mass index were associated with GI symptoms to varying degrees. Among treatment-related factors, rectum D2cm3 and the International Commission on Radiation Units and Measurements recto-vaginal reference point (ICRU RV-RP) correlated with G ≥3 anus/rectum events and moderate/persistent diarrhea, proctitis, bleeding, abdominal cramps, and difficulty in bowel control. Bowel D2cm3 correlated with G ≥3 sigmoid and colon/small bowel events and moderate/persistent diarrhea and flatulence. For external beam radiation therapy (EBRT), prescription dose correlated with G ≥3 anus/rectum, diarrhea, and difficulty in bowel control. Patients with large lymph-node boost (V57Gy) were at higher risk for G ≥3 sigmoid events, moderate/persistent diarrhea, proctitis, and cramps.Conclusions: The analysis showed that both EBRT and image guided adaptive brachytherapy contribute to GI symptoms after locally advanced cervical cancer treatment. Rectum D2cm3, ICRU RV-RP , and bowel D2cm3 are risk factors for GI morbidity. The risk for various symptoms was lower with an EBRT prescription of 45 Gy than 50 Gy and increased with larger V57Gy. Jensen, Nina B.K. verfasserin aut Pötter, Richard verfasserin aut Fokdal, Lars U. verfasserin aut Chargari, Cyrus verfasserin aut Lindegaard, Jacob C. verfasserin aut Schmid, Maximilian P. verfasserin aut Sturdza, Alina verfasserin aut Jürgenliemk-Schulz, Ina M. verfasserin aut Mahantshetty, Umesh verfasserin aut Hoskin, Peter verfasserin aut Segedin, Barbara verfasserin aut Rai, Bhavana verfasserin aut Bruheim, Kjersti verfasserin aut Wiebe, Ericka verfasserin aut Van der Steen-Banasik, Elzbieta verfasserin aut Cooper, Rachel verfasserin aut Van Limbergen, Erik verfasserin aut Sundset, Marit verfasserin aut Pieters, Bradley R. verfasserin aut Lutgens, Ludy C.H.W. verfasserin aut Tan, Li Tee verfasserin aut Villafranca, Elena verfasserin aut Smet, Stéphanie verfasserin aut Jastaniyah, Noha verfasserin aut Nout, Remi A. verfasserin aut Kirisits, Christian verfasserin aut Chopra, Supriya verfasserin aut Kirchheiner, Kathrin verfasserin aut Tanderup, Kari verfasserin aut EMBRACE Collaborative Group verfasserin aut Enthalten in International journal of radiation oncology, biology, physics Amsterdam [u.a.] : Elsevier Science, 1975 112 Online-Ressource (DE-627)306659662 (DE-600)1500486-7 (DE-576)081986319 1879-355X nnns volume:112 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_31 GBV_ILN_2011 44.64 Radiologie 44.81 Onkologie AR 112 |
| allfields_unstemmed |
10.1016/j.ijrobp.2021.09.055 doi (DE-627)ELV007332882 (ELSEVIER)S0360-3016(21)02915-1 DE-627 ger DE-627 rda eng 610 DE-600 44.64 bkl 44.81 bkl Spampinato, Sofia verfasserin (orcid)0000-0002-1953-7313 aut Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.Methods and Materials: Of 1416 patients from the EMBRACE-I study, 1199 and 1002 were prospectively evaluated using physician-assessed (Common Terminology Criteria for Adverse Events [CTCAE]) and patient-reported (European Organization for Research and Treatment of Cancer [EORTC]) GI symptoms, respectively. CTCAE severe grade (grade [G] ≥3) events were pooled according to the location in the GI tract (anus/rectum, sigmoid, and colon/small bowel). CTCAE G ≥2 and EORTC “very much” and “quite a bit” plus ”very much” scores (≥ ”quite a bit”) were analyzed for individual symptoms with Cox regression. Logistic regression was used for persistent G ≥1 and EORTC ≥ “quite a bit” symptoms, defined if present in at least half of follow-ups.Results: The incidence of G ≥3 events was 2.8%, 1.8%, and 2.3% for G ≥3 anus/rectum, sigmoid, and colon/small bowel events, respectively. Among G ≥2 symptoms, diarrhea and flatulence were the most prevalent (8.5% and 9.9%, respectively). Among patient-related factors, baseline morbidity, increasing age, smoking status, and low body mass index were associated with GI symptoms to varying degrees. Among treatment-related factors, rectum D2cm3 and the International Commission on Radiation Units and Measurements recto-vaginal reference point (ICRU RV-RP) correlated with G ≥3 anus/rectum events and moderate/persistent diarrhea, proctitis, bleeding, abdominal cramps, and difficulty in bowel control. Bowel D2cm3 correlated with G ≥3 sigmoid and colon/small bowel events and moderate/persistent diarrhea and flatulence. For external beam radiation therapy (EBRT), prescription dose correlated with G ≥3 anus/rectum, diarrhea, and difficulty in bowel control. Patients with large lymph-node boost (V57Gy) were at higher risk for G ≥3 sigmoid events, moderate/persistent diarrhea, proctitis, and cramps.Conclusions: The analysis showed that both EBRT and image guided adaptive brachytherapy contribute to GI symptoms after locally advanced cervical cancer treatment. Rectum D2cm3, ICRU RV-RP , and bowel D2cm3 are risk factors for GI morbidity. The risk for various symptoms was lower with an EBRT prescription of 45 Gy than 50 Gy and increased with larger V57Gy. Jensen, Nina B.K. verfasserin aut Pötter, Richard verfasserin aut Fokdal, Lars U. verfasserin aut Chargari, Cyrus verfasserin aut Lindegaard, Jacob C. verfasserin aut Schmid, Maximilian P. verfasserin aut Sturdza, Alina verfasserin aut Jürgenliemk-Schulz, Ina M. verfasserin aut Mahantshetty, Umesh verfasserin aut Hoskin, Peter verfasserin aut Segedin, Barbara verfasserin aut Rai, Bhavana verfasserin aut Bruheim, Kjersti verfasserin aut Wiebe, Ericka verfasserin aut Van der Steen-Banasik, Elzbieta verfasserin aut Cooper, Rachel verfasserin aut Van Limbergen, Erik verfasserin aut Sundset, Marit verfasserin aut Pieters, Bradley R. verfasserin aut Lutgens, Ludy C.H.W. verfasserin aut Tan, Li Tee verfasserin aut Villafranca, Elena verfasserin aut Smet, Stéphanie verfasserin aut Jastaniyah, Noha verfasserin aut Nout, Remi A. verfasserin aut Kirisits, Christian verfasserin aut Chopra, Supriya verfasserin aut Kirchheiner, Kathrin verfasserin aut Tanderup, Kari verfasserin aut EMBRACE Collaborative Group verfasserin aut Enthalten in International journal of radiation oncology, biology, physics Amsterdam [u.a.] : Elsevier Science, 1975 112 Online-Ressource (DE-627)306659662 (DE-600)1500486-7 (DE-576)081986319 1879-355X nnns volume:112 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_31 GBV_ILN_2011 44.64 Radiologie 44.81 Onkologie AR 112 |
| allfieldsGer |
10.1016/j.ijrobp.2021.09.055 doi (DE-627)ELV007332882 (ELSEVIER)S0360-3016(21)02915-1 DE-627 ger DE-627 rda eng 610 DE-600 44.64 bkl 44.81 bkl Spampinato, Sofia verfasserin (orcid)0000-0002-1953-7313 aut Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.Methods and Materials: Of 1416 patients from the EMBRACE-I study, 1199 and 1002 were prospectively evaluated using physician-assessed (Common Terminology Criteria for Adverse Events [CTCAE]) and patient-reported (European Organization for Research and Treatment of Cancer [EORTC]) GI symptoms, respectively. CTCAE severe grade (grade [G] ≥3) events were pooled according to the location in the GI tract (anus/rectum, sigmoid, and colon/small bowel). CTCAE G ≥2 and EORTC “very much” and “quite a bit” plus ”very much” scores (≥ ”quite a bit”) were analyzed for individual symptoms with Cox regression. Logistic regression was used for persistent G ≥1 and EORTC ≥ “quite a bit” symptoms, defined if present in at least half of follow-ups.Results: The incidence of G ≥3 events was 2.8%, 1.8%, and 2.3% for G ≥3 anus/rectum, sigmoid, and colon/small bowel events, respectively. Among G ≥2 symptoms, diarrhea and flatulence were the most prevalent (8.5% and 9.9%, respectively). Among patient-related factors, baseline morbidity, increasing age, smoking status, and low body mass index were associated with GI symptoms to varying degrees. Among treatment-related factors, rectum D2cm3 and the International Commission on Radiation Units and Measurements recto-vaginal reference point (ICRU RV-RP) correlated with G ≥3 anus/rectum events and moderate/persistent diarrhea, proctitis, bleeding, abdominal cramps, and difficulty in bowel control. Bowel D2cm3 correlated with G ≥3 sigmoid and colon/small bowel events and moderate/persistent diarrhea and flatulence. For external beam radiation therapy (EBRT), prescription dose correlated with G ≥3 anus/rectum, diarrhea, and difficulty in bowel control. Patients with large lymph-node boost (V57Gy) were at higher risk for G ≥3 sigmoid events, moderate/persistent diarrhea, proctitis, and cramps.Conclusions: The analysis showed that both EBRT and image guided adaptive brachytherapy contribute to GI symptoms after locally advanced cervical cancer treatment. Rectum D2cm3, ICRU RV-RP , and bowel D2cm3 are risk factors for GI morbidity. The risk for various symptoms was lower with an EBRT prescription of 45 Gy than 50 Gy and increased with larger V57Gy. Jensen, Nina B.K. verfasserin aut Pötter, Richard verfasserin aut Fokdal, Lars U. verfasserin aut Chargari, Cyrus verfasserin aut Lindegaard, Jacob C. verfasserin aut Schmid, Maximilian P. verfasserin aut Sturdza, Alina verfasserin aut Jürgenliemk-Schulz, Ina M. verfasserin aut Mahantshetty, Umesh verfasserin aut Hoskin, Peter verfasserin aut Segedin, Barbara verfasserin aut Rai, Bhavana verfasserin aut Bruheim, Kjersti verfasserin aut Wiebe, Ericka verfasserin aut Van der Steen-Banasik, Elzbieta verfasserin aut Cooper, Rachel verfasserin aut Van Limbergen, Erik verfasserin aut Sundset, Marit verfasserin aut Pieters, Bradley R. verfasserin aut Lutgens, Ludy C.H.W. verfasserin aut Tan, Li Tee verfasserin aut Villafranca, Elena verfasserin aut Smet, Stéphanie verfasserin aut Jastaniyah, Noha verfasserin aut Nout, Remi A. verfasserin aut Kirisits, Christian verfasserin aut Chopra, Supriya verfasserin aut Kirchheiner, Kathrin verfasserin aut Tanderup, Kari verfasserin aut EMBRACE Collaborative Group verfasserin aut Enthalten in International journal of radiation oncology, biology, physics Amsterdam [u.a.] : Elsevier Science, 1975 112 Online-Ressource (DE-627)306659662 (DE-600)1500486-7 (DE-576)081986319 1879-355X nnns volume:112 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_31 GBV_ILN_2011 44.64 Radiologie 44.81 Onkologie AR 112 |
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10.1016/j.ijrobp.2021.09.055 doi (DE-627)ELV007332882 (ELSEVIER)S0360-3016(21)02915-1 DE-627 ger DE-627 rda eng 610 DE-600 44.64 bkl 44.81 bkl Spampinato, Sofia verfasserin (orcid)0000-0002-1953-7313 aut Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.Methods and Materials: Of 1416 patients from the EMBRACE-I study, 1199 and 1002 were prospectively evaluated using physician-assessed (Common Terminology Criteria for Adverse Events [CTCAE]) and patient-reported (European Organization for Research and Treatment of Cancer [EORTC]) GI symptoms, respectively. CTCAE severe grade (grade [G] ≥3) events were pooled according to the location in the GI tract (anus/rectum, sigmoid, and colon/small bowel). CTCAE G ≥2 and EORTC “very much” and “quite a bit” plus ”very much” scores (≥ ”quite a bit”) were analyzed for individual symptoms with Cox regression. Logistic regression was used for persistent G ≥1 and EORTC ≥ “quite a bit” symptoms, defined if present in at least half of follow-ups.Results: The incidence of G ≥3 events was 2.8%, 1.8%, and 2.3% for G ≥3 anus/rectum, sigmoid, and colon/small bowel events, respectively. Among G ≥2 symptoms, diarrhea and flatulence were the most prevalent (8.5% and 9.9%, respectively). Among patient-related factors, baseline morbidity, increasing age, smoking status, and low body mass index were associated with GI symptoms to varying degrees. Among treatment-related factors, rectum D2cm3 and the International Commission on Radiation Units and Measurements recto-vaginal reference point (ICRU RV-RP) correlated with G ≥3 anus/rectum events and moderate/persistent diarrhea, proctitis, bleeding, abdominal cramps, and difficulty in bowel control. Bowel D2cm3 correlated with G ≥3 sigmoid and colon/small bowel events and moderate/persistent diarrhea and flatulence. For external beam radiation therapy (EBRT), prescription dose correlated with G ≥3 anus/rectum, diarrhea, and difficulty in bowel control. Patients with large lymph-node boost (V57Gy) were at higher risk for G ≥3 sigmoid events, moderate/persistent diarrhea, proctitis, and cramps.Conclusions: The analysis showed that both EBRT and image guided adaptive brachytherapy contribute to GI symptoms after locally advanced cervical cancer treatment. Rectum D2cm3, ICRU RV-RP , and bowel D2cm3 are risk factors for GI morbidity. The risk for various symptoms was lower with an EBRT prescription of 45 Gy than 50 Gy and increased with larger V57Gy. Jensen, Nina B.K. verfasserin aut Pötter, Richard verfasserin aut Fokdal, Lars U. verfasserin aut Chargari, Cyrus verfasserin aut Lindegaard, Jacob C. verfasserin aut Schmid, Maximilian P. verfasserin aut Sturdza, Alina verfasserin aut Jürgenliemk-Schulz, Ina M. verfasserin aut Mahantshetty, Umesh verfasserin aut Hoskin, Peter verfasserin aut Segedin, Barbara verfasserin aut Rai, Bhavana verfasserin aut Bruheim, Kjersti verfasserin aut Wiebe, Ericka verfasserin aut Van der Steen-Banasik, Elzbieta verfasserin aut Cooper, Rachel verfasserin aut Van Limbergen, Erik verfasserin aut Sundset, Marit verfasserin aut Pieters, Bradley R. verfasserin aut Lutgens, Ludy C.H.W. verfasserin aut Tan, Li Tee verfasserin aut Villafranca, Elena verfasserin aut Smet, Stéphanie verfasserin aut Jastaniyah, Noha verfasserin aut Nout, Remi A. verfasserin aut Kirisits, Christian verfasserin aut Chopra, Supriya verfasserin aut Kirchheiner, Kathrin verfasserin aut Tanderup, Kari verfasserin aut EMBRACE Collaborative Group verfasserin aut Enthalten in International journal of radiation oncology, biology, physics Amsterdam [u.a.] : Elsevier Science, 1975 112 Online-Ressource (DE-627)306659662 (DE-600)1500486-7 (DE-576)081986319 1879-355X nnns volume:112 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_31 GBV_ILN_2011 44.64 Radiologie 44.81 Onkologie AR 112 |
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severity and persistency of late gastrointestinal morbidity in locally advanced cervical cancer: lessons learned from embrace-i and implications for the future |
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Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future |
| abstract |
Purpose: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.Methods and Materials: Of 1416 patients from the EMBRACE-I study, 1199 and 1002 were prospectively evaluated using physician-assessed (Common Terminology Criteria for Adverse Events [CTCAE]) and patient-reported (European Organization for Research and Treatment of Cancer [EORTC]) GI symptoms, respectively. CTCAE severe grade (grade [G] ≥3) events were pooled according to the location in the GI tract (anus/rectum, sigmoid, and colon/small bowel). CTCAE G ≥2 and EORTC “very much” and “quite a bit” plus ”very much” scores (≥ ”quite a bit”) were analyzed for individual symptoms with Cox regression. Logistic regression was used for persistent G ≥1 and EORTC ≥ “quite a bit” symptoms, defined if present in at least half of follow-ups.Results: The incidence of G ≥3 events was 2.8%, 1.8%, and 2.3% for G ≥3 anus/rectum, sigmoid, and colon/small bowel events, respectively. Among G ≥2 symptoms, diarrhea and flatulence were the most prevalent (8.5% and 9.9%, respectively). Among patient-related factors, baseline morbidity, increasing age, smoking status, and low body mass index were associated with GI symptoms to varying degrees. Among treatment-related factors, rectum D2cm3 and the International Commission on Radiation Units and Measurements recto-vaginal reference point (ICRU RV-RP) correlated with G ≥3 anus/rectum events and moderate/persistent diarrhea, proctitis, bleeding, abdominal cramps, and difficulty in bowel control. Bowel D2cm3 correlated with G ≥3 sigmoid and colon/small bowel events and moderate/persistent diarrhea and flatulence. For external beam radiation therapy (EBRT), prescription dose correlated with G ≥3 anus/rectum, diarrhea, and difficulty in bowel control. Patients with large lymph-node boost (V57Gy) were at higher risk for G ≥3 sigmoid events, moderate/persistent diarrhea, proctitis, and cramps.Conclusions: The analysis showed that both EBRT and image guided adaptive brachytherapy contribute to GI symptoms after locally advanced cervical cancer treatment. Rectum D2cm3, ICRU RV-RP , and bowel D2cm3 are risk factors for GI morbidity. The risk for various symptoms was lower with an EBRT prescription of 45 Gy than 50 Gy and increased with larger V57Gy. |
| abstractGer |
Purpose: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.Methods and Materials: Of 1416 patients from the EMBRACE-I study, 1199 and 1002 were prospectively evaluated using physician-assessed (Common Terminology Criteria for Adverse Events [CTCAE]) and patient-reported (European Organization for Research and Treatment of Cancer [EORTC]) GI symptoms, respectively. CTCAE severe grade (grade [G] ≥3) events were pooled according to the location in the GI tract (anus/rectum, sigmoid, and colon/small bowel). CTCAE G ≥2 and EORTC “very much” and “quite a bit” plus ”very much” scores (≥ ”quite a bit”) were analyzed for individual symptoms with Cox regression. Logistic regression was used for persistent G ≥1 and EORTC ≥ “quite a bit” symptoms, defined if present in at least half of follow-ups.Results: The incidence of G ≥3 events was 2.8%, 1.8%, and 2.3% for G ≥3 anus/rectum, sigmoid, and colon/small bowel events, respectively. Among G ≥2 symptoms, diarrhea and flatulence were the most prevalent (8.5% and 9.9%, respectively). Among patient-related factors, baseline morbidity, increasing age, smoking status, and low body mass index were associated with GI symptoms to varying degrees. Among treatment-related factors, rectum D2cm3 and the International Commission on Radiation Units and Measurements recto-vaginal reference point (ICRU RV-RP) correlated with G ≥3 anus/rectum events and moderate/persistent diarrhea, proctitis, bleeding, abdominal cramps, and difficulty in bowel control. Bowel D2cm3 correlated with G ≥3 sigmoid and colon/small bowel events and moderate/persistent diarrhea and flatulence. For external beam radiation therapy (EBRT), prescription dose correlated with G ≥3 anus/rectum, diarrhea, and difficulty in bowel control. Patients with large lymph-node boost (V57Gy) were at higher risk for G ≥3 sigmoid events, moderate/persistent diarrhea, proctitis, and cramps.Conclusions: The analysis showed that both EBRT and image guided adaptive brachytherapy contribute to GI symptoms after locally advanced cervical cancer treatment. Rectum D2cm3, ICRU RV-RP , and bowel D2cm3 are risk factors for GI morbidity. The risk for various symptoms was lower with an EBRT prescription of 45 Gy than 50 Gy and increased with larger V57Gy. |
| abstract_unstemmed |
Purpose: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.Methods and Materials: Of 1416 patients from the EMBRACE-I study, 1199 and 1002 were prospectively evaluated using physician-assessed (Common Terminology Criteria for Adverse Events [CTCAE]) and patient-reported (European Organization for Research and Treatment of Cancer [EORTC]) GI symptoms, respectively. CTCAE severe grade (grade [G] ≥3) events were pooled according to the location in the GI tract (anus/rectum, sigmoid, and colon/small bowel). CTCAE G ≥2 and EORTC “very much” and “quite a bit” plus ”very much” scores (≥ ”quite a bit”) were analyzed for individual symptoms with Cox regression. Logistic regression was used for persistent G ≥1 and EORTC ≥ “quite a bit” symptoms, defined if present in at least half of follow-ups.Results: The incidence of G ≥3 events was 2.8%, 1.8%, and 2.3% for G ≥3 anus/rectum, sigmoid, and colon/small bowel events, respectively. Among G ≥2 symptoms, diarrhea and flatulence were the most prevalent (8.5% and 9.9%, respectively). Among patient-related factors, baseline morbidity, increasing age, smoking status, and low body mass index were associated with GI symptoms to varying degrees. Among treatment-related factors, rectum D2cm3 and the International Commission on Radiation Units and Measurements recto-vaginal reference point (ICRU RV-RP) correlated with G ≥3 anus/rectum events and moderate/persistent diarrhea, proctitis, bleeding, abdominal cramps, and difficulty in bowel control. Bowel D2cm3 correlated with G ≥3 sigmoid and colon/small bowel events and moderate/persistent diarrhea and flatulence. For external beam radiation therapy (EBRT), prescription dose correlated with G ≥3 anus/rectum, diarrhea, and difficulty in bowel control. Patients with large lymph-node boost (V57Gy) were at higher risk for G ≥3 sigmoid events, moderate/persistent diarrhea, proctitis, and cramps.Conclusions: The analysis showed that both EBRT and image guided adaptive brachytherapy contribute to GI symptoms after locally advanced cervical cancer treatment. Rectum D2cm3, ICRU RV-RP , and bowel D2cm3 are risk factors for GI morbidity. The risk for various symptoms was lower with an EBRT prescription of 45 Gy than 50 Gy and increased with larger V57Gy. |
| collection_details |
GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_31 GBV_ILN_2011 |
| title_short |
Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future |
| remote_bool |
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| author2 |
Jensen, Nina B.K. Pötter, Richard Fokdal, Lars U. Chargari, Cyrus Lindegaard, Jacob C. Schmid, Maximilian P. Sturdza, Alina Jürgenliemk-Schulz, Ina M. Mahantshetty, Umesh Hoskin, Peter Segedin, Barbara Rai, Bhavana Bruheim, Kjersti Wiebe, Ericka Van der Steen-Banasik, Elzbieta Cooper, Rachel Van Limbergen, Erik Sundset, Marit Pieters, Bradley R. Lutgens, Ludy C.H.W. Tan, Li Tee Villafranca, Elena Smet, Stéphanie Jastaniyah, Noha Nout, Remi A. Kirisits, Christian Chopra, Supriya Kirchheiner, Kathrin Tanderup, Kari EMBRACE Collaborative Group |
| author2Str |
Jensen, Nina B.K. Pötter, Richard Fokdal, Lars U. Chargari, Cyrus Lindegaard, Jacob C. Schmid, Maximilian P. Sturdza, Alina Jürgenliemk-Schulz, Ina M. Mahantshetty, Umesh Hoskin, Peter Segedin, Barbara Rai, Bhavana Bruheim, Kjersti Wiebe, Ericka Van der Steen-Banasik, Elzbieta Cooper, Rachel Van Limbergen, Erik Sundset, Marit Pieters, Bradley R. Lutgens, Ludy C.H.W. Tan, Li Tee Villafranca, Elena Smet, Stéphanie Jastaniyah, Noha Nout, Remi A. Kirisits, Christian Chopra, Supriya Kirchheiner, Kathrin Tanderup, Kari EMBRACE Collaborative Group |
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| doi_str |
10.1016/j.ijrobp.2021.09.055 |
| up_date |
2024-07-07T00:23:40.114Z |
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1803877687091003392 |
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