| Author/Editor | Kibsgaard Jensen, Nina Boje; Pötter, Richard; Kirchheiner, Kathrin; Fokdal, Lars U.; Lindegaard, Jacob Christian; Kirisits, Christian; Mazeron, Renaud; Mahantshetty, Umesh; Jürgenliemk-Schulz, Ina Maria; Šegedin, Barbara | |
| Title | Bowel morbidity following radiochemotherapy and image-guided adaptive brachytherapy for cervical cancer | |
| Type | članek | |
| Vol. and No. | Letnik 127, št. 3 | |
| Publication year | 2018 | |
| Volume | str. 431-439 | |
| ISSN | 0167-8140 - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology | |
| Language | eng | |
| Abstract | This study describes late bowel morbidity prospectively assessed in the multi-institutional EMBRACE study on MRI-guided adaptive brachytherapy in locally advanced cervical cancer (LACC). Materials/Methods A total of 1176 patients were analyzed. Physician reported morbidity (CTCAE v.3.0) and patient reported outcome (PRO) (EORTC QLQ C30/CX24) were assessed at baseline and at regular follow-up. Results At 3/5%years the actuarial incidence of bowel morbidity grade 3%4 was 5.0%/5.9%, including incidence of stenosis/stricture/fistula of 2.0%/2.6%. Grade 1%2 morbidity was pronounced with prevalence rates of 28%33% during follow-up. Diarrhea and flatulence were most frequently reported, significantly increased after 3%months and remained elevated during follow-up. Incontinence gradually worsened with time. PRO revealed high prevalence rates. Diarrhea %%a little% increased from 26% to 37% at baseline to 3%months and remained elevated, difficulty in controlling bowel increased from 11% to 26% at baseline to 3%months gradually worsening with time. Constipation and abdominal cramps improved after treatment. Conclusion Bowel morbidity reported in this large cohort of LACC patients was limited regarding severe/life-threatening events. Mild-moderate diarrhea, flatulence and incontinence were prevalent after treatment with PROs indicating a considerable and clinically relevant burden. Critical knowledge based on the extent and manifestation pattern of treatment-related morbidity will serve future patient management. | |
| Keywords | rak materničnega vratu radiokemoterapija brahiterapija obsevanje cervical cancer radiochemotherapy brachytherapy radiotherapy |