Avtor/Urednik		Najjari Jamal, Dina; Pötter, Richard; Haie-Meder, Christine; Lindegaard, Jacob Christian; Jürgenliemk-Schulz, Ina Maria; Mahantshetty, Umesh; Šegedin, Barbara; Bruheim, Kjesti; Hoskin, Peter J.; Rai, Bhavana
Naslov		Physician assessed and patient reported lower limb edema after defnitive radio(chemo)therapy and image-guided adaptive brachytherapy for locally advanced cervical cancer
Tip		članek
Vol. in št.		Letnik 127, št. 3
Leto izdaje		2018
Obseg		str. 449-455
ISSN		0167-8140 - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Jezik		eng
Abstrakt		Background/purpose To evaluate the pattern of manifestation and risk factors for lower limb edema (LLE) within the prospective, observational, multi-center EMBRACE study on radiochemotherapy and MRI-guided brachytherapy in locally advanced cervical cancer (LACC). Material/methods LLE was prospectively assessed according to the physician-reported CTCAE v.3 and patient-reported EORTC QLQ-CX24 questionnaire at baseline and regular follow-up. Results In total, 1176 patients were evaluated with a median follow-up of 27%months. Actuarial analyses revealed 3/5-year estimates of 27%/31% of CTCAE G%%%1, 6.1%/6.6% of G%%%2 and 0.5%/0.5% for G%%%3. Prevalence rates for G%%%1 LLE at 3%months, 1, 3 and 5%years after end of treatment were 7%, 12%, 12%, 15% for physician-assessed and 25%, 30%, 30%, 34% for any patient-reported symptoms and showed a steady increase over time. Invasive lymph node staging and obesity at diagnosis are independent significant risk factors for G%%%1 LLE, whereas nodal boost has no impact. Extended radiation fields including para-aortic and/or inguinal nodes show a tendency to increase the risk. Conclusion Severe LLE after definitive radiochemotherapy in LACC is rare. However, the risk for mild LLE is considerable, and related to patient-, diagnostic- and treatment characteristics. Less invasive diagnostic surgical procedures or non-invasive assessment, less invasive radiotherapy management and active rehabilitation are important pathways for future developments.
Proste vsebinske oznake		rak materničnega vratu lokalno napredovali rak brahiterapija obsevanje cervical cancer locally advanced cervical cancer brachytherapy radiotherapy