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De-escalation of the cumulative central radiation dose according to the tumor response can reduce rectal toxicity without compromising the treatment outcome in patients with uterine cervical cancer

DC Field Value Language
dc.contributor.author금웅섭-
dc.contributor.author김경환-
dc.contributor.author김상운-
dc.contributor.author김성훈-
dc.contributor.author김용배-
dc.contributor.author남은지-
dc.contributor.author서창옥-
dc.date.accessioned2018-03-26T16:55:46Z-
dc.date.available2018-03-26T16:55:46Z-
dc.date.issued2015-
dc.identifier.issn0090-8258-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/156972-
dc.description.abstractOBJECTIVE: To assess the treatment outcome and toxicity of a low cumulative central dose using a midline block (MLB) during external beam radiotherapy (EBRT). METHODS: Between January 1988 and December 2010, 1559 patients with FIGO stage IB-IIB uterine cervical cancer that underwent EBRT and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were retrospectively analyzed. During EBRT, MLB was performed (n=1195, MLB group) when a sufficient response was achieved to insert the tandem through the cervical canal and place ovoids in the vaginal cavity. MLB was not applied for patients with a slow tumor response (n=364, non-MLB group). The doses were estimated according to the International Commission on Radiation Units and Measurements (ICRU) points. The biologically equivalent dose in 2-Gy fractions (EQD2) was calculated to estimate the cumulative dose from EBRT and ICBT. RESULTS: EQD2pointA, EQD2rectum, and EQD2bladder were all significantly lower in the MLB group (all P<0.05). The 10-year grade≥2 late rectal toxicity rate was significantly lower in the MLB group (P=0.012), while there was no significant difference in late genitourinary and small bowel toxicity. ICRU rectal and bladder doses showed significant predictability on late rectal and bladder toxicities. After propensity score matching, all patient and tumor characteristics were well matched and the survival and recurrence rates between the two groups were similar (all P>0.05), despite the lower EQD2pointA in the MLB group (P<0.001). CONCLUSIONS: Applying MLB according to tumor response during EBRT lowered the cumulative central dose and reduced late rectal toxicity without compromising treatment outcome.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherAcademic Press-
dc.relation.isPartOfGYNECOLOGIC ONCOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHBrachytherapy/adverse effects-
dc.subject.MESHBrachytherapy/methods-
dc.subject.MESHCarcinoma/radiotherapy*-
dc.subject.MESHCarcinoma/secondary-
dc.subject.MESHDisease-Free Survival-
dc.subject.MESHFemale-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHHumans-
dc.subject.MESHMiddle Aged-
dc.subject.MESHRadiation Injuries/etiology-
dc.subject.MESHRadiation Injuries/prevention & control*-
dc.subject.MESHRadiotherapy/adverse effects*-
dc.subject.MESHRadiotherapy/methods*-
dc.subject.MESHRadiotherapy Dosage-
dc.subject.MESHRectum/radiation effects*-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHSurvival Rate-
dc.subject.MESHTime Factors-
dc.subject.MESHUrinary Bladder/radiation effects-
dc.subject.MESHUterine Cervical Neoplasms/pathology-
dc.subject.MESHUterine Cervical Neoplasms/radiotherapy*-
dc.subject.MESHYoung Adult-
dc.titleDe-escalation of the cumulative central radiation dose according to the tumor response can reduce rectal toxicity without compromising the treatment outcome in patients with uterine cervical cancer-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Radiation Oncology-
dc.contributor.googleauthorKyung Hwan Kim-
dc.contributor.googleauthorSunghoon Kim-
dc.contributor.googleauthorGwi Eon Kim-
dc.contributor.googleauthorWoong Sub Koom-
dc.contributor.googleauthorSangWun Kim-
dc.contributor.googleauthorEun Ji Nam-
dc.contributor.googleauthorChang-Ok Suh-
dc.contributor.googleauthorYong Bae Kim-
dc.identifier.doi10.1016/j.ygyno.2015.10.005-
dc.contributor.localIdA00273-
dc.contributor.localIdA05226-
dc.contributor.localIdA00526-
dc.contributor.localIdA00595-
dc.contributor.localIdA00744-
dc.contributor.localIdA01262-
dc.contributor.localIdA01919-
dc.relation.journalcodeJ00956-
dc.identifier.eissn1095-6859-
dc.identifier.pmid26456139-
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S0090825815301542-
dc.subject.keywordMidline block-
dc.subject.keywordRadiotherapy-
dc.subject.keywordToxicity-
dc.subject.keywordUterine cervical cancer-
dc.contributor.alternativeNameKoom, Woong Sub-
dc.contributor.alternativeNameKim, Kyung Hwan-
dc.contributor.alternativeNameKim, Sang Wun-
dc.contributor.alternativeNameKim, Sung Hoon-
dc.contributor.alternativeNameKim, Yong Bae-
dc.contributor.alternativeNameNam, Eun Ji-
dc.contributor.alternativeNameSuh, Chang Ok-
dc.contributor.affiliatedAuthorKoom, Woong Sub-
dc.contributor.affiliatedAuthorKim, Kyung Hwan-
dc.contributor.affiliatedAuthorKim, Sang Wun-
dc.contributor.affiliatedAuthorKim, Sung Hoon-
dc.contributor.affiliatedAuthorKim, Yong Bae-
dc.contributor.affiliatedAuthorNam, Eun Ji-
dc.contributor.affiliatedAuthorSuh, Chang Ok-
dc.citation.volume139-
dc.citation.number3-
dc.citation.startPage439-
dc.citation.endPage446-
dc.identifier.bibliographicCitationGYNECOLOGIC ONCOLOGY, Vol.139(3) : 439-446, 2015-
dc.identifier.rimsid41281-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers

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