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Verfasst von:Akbaba, Sati [VerfasserIn]   i
 Oelmann-Avendano, Jan Tobias [VerfasserIn]   i
 Bostel, Tilman [VerfasserIn]   i
 Rief, Harald [VerfasserIn]   i
 Nicolay, Nils [VerfasserIn]   i
 Debus, Jürgen [VerfasserIn]   i
 Lindel, Katja [VerfasserIn]   i
 Förster, Robert [VerfasserIn]   i
Titel:Percutaneous parametrial dose escalation in women with advanced cervical cancer
Titelzusatz:feasibility and efficacy in relation to long-term quality of life
Verf.angabe:Sati Akbaba, Jan Tobias Oelmann-Avendano, Tilman Bostel, Harald Rief, Nils Henrik Nicolay, Juergen Debus, Katja Lindel und Robert Foerster M.D.
E-Jahr:2018
Jahr:09 May 2018
Umfang:9 S.
Fussnoten:Gesehen am 29.04.2020
Titel Quelle:Enthalten in: Radiology and oncology
Ort Quelle:Warsaw : Sciendo, 2001
Jahr Quelle:2018
Band/Heft Quelle:52(2018), 3, Seite 320-328
ISSN Quelle:1581-3207
Abstract:<section class="abstract"><h2 class="abstractTitle text-title my-1" id="d6e2">Abstract</h2><div id="j_raon-2018-0029_s_001_w2aab2b8b8b1b7b1aab1c16b1Aa" class="section"><h3 class="abstractTitle text-title my-1" id="d6e5">Background</h3><p>We analyzed long-term quality of life (QoL) and prognostic factors for QoL as well as clinical outcome in patients with advanced cervical cancer (ACC) treated with primary radiochemotherapy (RChT) consisting of external beam radiotherapy (EBRT) with or without sequential or simultaneous integrated boost (SIB) to the parametria, intracavitary brachytherapy and concomitant chemotherapy (ChT).</p></div><div id="j_raon-2018-0029_s_002_w2aab2b8b8b1b7b1aab1c16b2Aa" class="section"><h3 class="abstractTitle text-title my-1" id="d6e8">Patients and methods</h3><p>Eighty-three women were treated with primary RChT between 2008 and 2014. Survival of all patients was calculated and prognostic factors for survival were assessed in univariate and multivariate analysis. In 31 patients QoL was assessed in median 3 years (range 2-8 years) after treatment. QoL was compared to published normative data and the influence of age, tumour stage, treatment and observed acute toxicities was analyzed.</p></div><div id="j_raon-2018-0029_s_003_w2aab2b8b8b1b7b1aab1c16b3Aa" class="section"><h3 class="abstractTitle text-title my-1" id="d6e11">Results</h3><p>Thirty-six patients (43.4%) died, 18 (21.7%) had a local recurrence and 24 (28.9%) had a distant progression. Parametrial boost (p = 0.027) and ChT (p = 0.041) were independent prognostic factors for overall survival in multivariate analysis. Specifically, a parametrial equivalent doses in 2-Gy fractions (EQD2) > 50 Gy was associated with an improved overall survival (OS) (p = 0.020), but an EQD2 > 53 Gy did not further improve OS (p = 0.194). Tumour size was the only independent prognostic factor for local control (p = 0.034). Lymph node status (p = 0.038) and distant metastases other than in paraaortic lymph nodes (p = 0.002) were independent prognostic factors for distant progressionfree survival. QoL was generally inferior to the reference population. Age only correlated with menopausal symptoms (p = 0.003). The degree of acute gastrointestinal (p = 0.038) and genitourinary (p = 0.041) toxicities correlated with the extent of chronic symptom experience. Sexual/vaginal functioning was reduced in patients with larger tumours (p = 0.012). Parametrial EQD2 > 53 Gy correlated with reduced sexual/vaginal functioning (p = 0.009) and increased sexual worry (p = 0.009). Whether parametrial dose escalation was achieved by sequential boost or SIB, did not affect survival or QoL.</p></div><div id="j_raon-2018-0029_s_004_w2aab2b8b8b1b7b1aab1c16b4Aa" class="section"><h3 class="abstractTitle text-title my-1" id="d6e14">Conclusions</h3><p>Primary RChT is an effective treatment, but long-term QoL is reduced. The degree of acute side effects of RChT correlates with the extent of chronic symptoms. Patients benefit from parametrial SIB or sequential boost, but an EQD2 > 53 Gy does not further improve survival and negatively affects QoL.</p></div></section>
DOI:doi:10.2478/raon-2018-0029
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext ; Verlag: https://doi.org/10.2478/raon-2018-0029
 Volltext: https://content.sciendo.com/view/journals/raon/52/3/article-p320.xml
 DOI: https://doi.org/10.2478/raon-2018-0029
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1696876621
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