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Risk factors for ureteral stricture after radiochemotherapy including image guided adaptive brachytherapy in cervical cancer : results from the EMBRACE studiesFokdal, Lars U. ...Ureteral stricture is a rare but severe side effect of radiation therapy for locally advanced cervical cancer. This report describes the incidence and risk factors for ureteral stricture in a large ... patient cohort treated with 3-dimensional image guided adaptive brachytherapy and radiochemotherapy within the EMBRACE studies. Methods and materials: A total of 1860 patients were included. Treatment consisted of external beam radiation therapy (45-50 Gy in 25-30 fractions), concomitant cisplatin, and image guided adaptive brachytherapy. Grade 3 to 4 ureteral strictures were assessed with Common Terminology Criteria for Adverse Events v. 3.0. Risk factors for grade 3 to 4 ureteral stricture were analyzed. These factors included age, hydronephrosis on imaging at time of diagnosis, TNM stage, high-risk clinical target volume, laparoscopic staging, chemotherapy, radiation therapy doses to targets and organs at risk, applicator type, intracavitary versus intracavitary/interstitial technique, and dose rate. Results: At a median follow-up of 34 months (range, 2-163), 31 patients received diagnoses of grade 3 to 4 ureteral stricture. Actuarial 3- and 5-year risk for ureteral stricture grade 3 to 4 was 1.7% and 2.1%, respectively, for all patients. Advanced tumor stage T3-4 with hydronephrosis at diagnosis was the only independent risk factors for ureteral stricture (P = .01). Patients with TNM stage T1 (n = 359) had a low risk of 0.4% and 1.0% at 3 and 5 years, and those with T2 (n = 1085) had a low risk of 1.0% and 1.0% at 3 and 5 years, respectively. Patients (n = 274) with T3-T4 without hydronephrosis at diagnosis had a 3- and 5-year risk of 2.2% and 4.8%, respectively, compared with 11.5% and 11.5%, respectively, in those with baseline hydronephrosis (n = 142). Conclusions: Severe to life-threatening ureteral stricture occurs rarely in patients with locally advanced cervical cancer with T1-2 tumors. The risk for ureteral stricture is significantly increased in patients with T3-T4 tumors with hydronephrosis at diagnosis.Vir: International journal of radiation oncology, biology, physics. - ISSN 0360-3016 (Vol. 103, no. 4, 2019, str. 887-894)Vrsta gradiva - članek, sestavni delLeto - 2019Jezik - angleškiCOBISS.SI-ID - 31720195
Avtor
Fokdal, Lars U. |
Tanderup, Kari |
Pötter, Richard |
Sturdza, Alina |
Kirchheiner, Kathrin |
Chagari, Cyrus |
Jürgenliemk-Schulz, Ina Maria |
Šegedin, Barbara |
Tan, Li-Tee |
Hoskin, Peter J.
Teme
brahiterapija |
radiokemoterapija |
rak materničnega vratu |
brachytherapy |
radiochemotherapy |
cervical cancer
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vir: International journal of radiation oncology, biology, physics. - ISSN 0360-3016 (Vol. 103, no. 4, 2019, str. 887-894)
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Baze podatkov, v katerih je revija indeksirana
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Fokdal, Lars U. | ![]() |
Tanderup, Kari | ![]() |
Pötter, Richard | ![]() |
Sturdza, Alina | ![]() |
Kirchheiner, Kathrin | ![]() |
Chagari, Cyrus | ![]() |
Jürgenliemk-Schulz, Ina Maria | ![]() |
Šegedin, Barbara | 27754 |
Tan, Li-Tee | ![]() |
Hoskin, Peter J. | ![]() |
Vir: Osebne bibliografije
in: SICRIS
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