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Spampinato S, Jensen NBK, Pötter R, et al. Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future. Int J Radiat Oncol Biol Phys. 2021;doi: 10.1016/j.ijrobp.2021.09.055.
Spampinato, S., Jensen, N. B. K., Pötter, R., Fokdal, L. U., Chargari, C., Lindegaard, J. C., Schmid, M. P., Sturdza, A., Jürgenliemk-Schulz, I. M., Mahantshetty, U., Hoskin, P., Segedin, B., Rai, B., Bruheim, K., Wiebe, E., Van der Steen-Banasik, E., Cooper, R., Van Limbergen, E., Sundset, M., Pieters, B. R., Lutgens, L. C. H. W., Tan, L. T., Villafranca, E., Smet, S., Jastaniyah, N., Nout, R. A., Kirisits, C., Chopra, S., Kirchheiner, K., Tanderup, K., & Embrace Collaborative Group. (2021). Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future. International journal of radiation oncology, biology, physics, . https://doi.org/10.1016/j.ijrobp.2021.09.055
Spampinato, Sofia, et al. "Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future." International journal of radiation oncology, biology, physics vol. (2021). doi: https://doi.org/10.1016/j.ijrobp.2021.09.055
Spampinato S, Jensen NBK, Pötter R, Fokdal LU, Chargari C, Lindegaard JC, Schmid MP, Sturdza A, Jürgenliemk-Schulz IM, Mahantshetty U, Hoskin P, Segedin B, Rai B, Bruheim K, Wiebe E, Van der Steen-Banasik E, Cooper R, Van Limbergen E, Sundset M, Pieters BR, Lutgens LCHW, Tan LT, Villafranca E, Smet S, Jastaniyah N, Nout RA, Kirisits C, Chopra S, Kirchheiner K, Tanderup K, Embrace Collaborative Group. Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future. Int J Radiat Oncol Biol Phys. 2021 Oct 20; doi: 10.1016/j.ijrobp.2021.09.055. Epub 2021 Oct 20. PMID: 34678431.
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Int J Radiat Oncol Biol Phys. 2021 Oct 20; doi: 10.1016/j.ijrobp.2021.09.055. Epub 2021 Oct 20.

Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future.

International journal of radiation oncology, biology, physics

Sofia Spampinato, Nina B K Jensen, Richard Pötter, Lars U Fokdal, Cyrus Chargari, Jacob C Lindegaard, Maximilian P Schmid, Alina Sturdza, Ina M Jürgenliemk-Schulz, Umesh Mahantshetty, Peter Hoskin, Barbara Segedin, Bhavana Rai, Kjersti Bruheim, Ericka Wiebe, Elzbieta Van der Steen-Banasik, Rachel Cooper, Erik Van Limbergen, Marit Sundset, Bradley R Pieters, Ludy C H W Lutgens, Li Tee Tan, Elena Villafranca, Stéphanie Smet, Noha Jastaniyah, Remi A Nout, Christian Kirisits, Supriya Chopra, Kathrin Kirchheiner, Kari Tanderup, Embrace Collaborative Group

Affiliations

  1. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: [email protected].
  2. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
  3. Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
  4. Department of Radiotherapy, Gustave-Roussy, Villejuif, France.
  5. Department of Radiation Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands.
  6. Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai and Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, India.
  7. Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood, United Kingdom.
  8. Department of Radiotherapy, Institute of Oncology, Ljubljana, Slovenia, Faculty of Medicine, University of Ljubljana.
  9. Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
  10. Department of Oncology, Oslo University Hospital, Oslo, Norway.
  11. Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, Canada.
  12. Department of Radiotherapy, Radiotherapiegroep Arnhem, Arnhem, The Netherlands.
  13. Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom.
  14. Department of Radiation Oncology, University Hospital Leuven, Leuven, Belgium.
  15. Clinic of Oncology and Women's Clinic, St. Olavs Hospital, Trondheim, Norway.
  16. Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
  17. Maastricht Radiation Oncology (MAASTRO) clinic, Maastricht, The Netherlands.
  18. Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
  19. Department of Radiation Oncology, Hospital of Navarra, Pamplona, Spain.
  20. Department of Radiation Oncology, Algemeen Ziekenhuis Turnhout, Turnhout, Belgium.
  21. Radiation Oncology Section, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
  22. Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
  23. Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India.
  24. See Supplementary Materials.

PMID: 34678431 DOI: 10.1016/j.ijrobp.2021.09.055

Abstract

PURPOSE: The purpose was to evaluate patient- and treatment-related risk factors for physician-assessed and patient-reported gastrointestinal (GI) symptoms after radio(chemo)therapy and image guided adaptive brachytherapy in locally advanced cervical cancer.

METHODS AND MATERIALS: Of 1416 patients from the EMBRACE-I study, 1199 and 1002 were prospectively evaluated using physician-assessed (Common Terminology Criteria for Adverse Events [CTCAE]) and patient-reported (European Organization for Research and Treatment of Cancer [EORTC]) GI symptoms, respectively. CTCAE severe grade (grade [G] ≥3) events were pooled according to the location in the GI tract (anus/rectum, sigmoid, and colon/small bowel). CTCAE G ≥2 and EORTC "very much" and "quite a bit" plus "very much" scores (≥ "quite a bit") were analyzed for individual symptoms with Cox regression. Logistic regression was used for persistent G ≥1 and EORTC ≥ "quite a bit" symptoms, defined if present in at least half of follow-ups.

RESULTS: The incidence of G ≥3 events was 2.8%, 1.8%, and 2.3% for G ≥3 anus/rectum, sigmoid, and colon/small bowel events, respectively. Among G ≥2 symptoms, diarrhea and flatulence were the most prevalent (8.5% and 9.9%, respectively). Among patient-related factors, baseline morbidity, increasing age, smoking status, and low body mass index were associated with GI symptoms to varying degrees. Among treatment-related factors, rectum D

CONCLUSIONS: The analysis showed that both EBRT and image guided adaptive brachytherapy contribute to GI symptoms after locally advanced cervical cancer treatment. Rectum D

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