Evidence map›Paper›PMID 26597282›Full record

ArticleRadiation oncology (London, England)2015

Dose escalated intensity modulated radiotherapy in the treatment of cervical cancer.

Nikola Cihoric, Alexandros Tsikkinis, Coya Tapia, Daniel M Aebersold, Inti Zlobec, Kristina Lössl

Abstract read
In one paragraph

Article in Radiation oncology (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Nikola CihoricDepartment of Radiation Oncology, Bern University Hospital & University of Bern, Bern, Switzerland. nikola.cihoric@gmail.com.
Alexandros TsikkinisDepartment of Radiation Oncology, Bern University Hospital & University of Bern, Bern, Switzerland. alexandros.tsikkinis@insel.ch.
Coya TapiaUniversity of Bern, Institute for Pathology, Murtenstrasse 31, Bern, 3010, Switzerland. CTapia1@mdanderson.org.
Daniel M AebersoldDepartment of Radiation Oncology, Bern University Hospital & University of Bern, Bern, Switzerland. daniel.aebersold@insel.ch.
Inti ZlobecUniversity of Bern, Institute for Pathology, Murtenstrasse 31, Bern, 3010, Switzerland. inti.zlobec@pathology.unibe.ch.
Kristina LösslDepartment of Radiation Oncology, Bern University Hospital & University of Bern, Bern, Switzerland. kristina.loessl@insel.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeStandard dose of external beam radiotherapy seems to be insufficient for satisfactory control of loco-regionally advanced cervical cancer. Aim of our study is to evaluate the outcome as well as early and chronic toxicities in patients with loco-regionally advanced cervical cancer, treated with dose escalated intensity modulated radiotherapy (IMRT) combined with cisplatin chemotherapy. MATERIAL AND

methodsThirty-nine patients with cervical carcinoma FIGO stage IB2 - IVA were treated with curative intent between 2006 and 2010. The dose of 50.4 Gy was prescribed to the elective pelvic nodal volume. Primary tumors < 4 cm in diameter (n = 6; 15.4 %) received an external beam radiotherapy (EBRT) boost of 5.4 Gy, primary tumors > 4 cm in diameter (n = 33; 84.6 %) received an EBRT boost of 9 Gy. Patients with positive lymph nodes detected with (18)FDG-PET/CT (n = 22; 56.4 %) received a boost to a total dose of 59.4 - 64.8 Gy. The para-aortic region was included in the radiation volume in 8 (20.5 %) patients and in 5 (12.8 %) patients the para-aortic macroscopic lymph nodes received an EBRT boost. IMRT was followed with a 3D planned high dose rate intrauterine brachytherapy given to 36 (92.3 %) patients with a total dose ranging between 15-18 Gy in three fractions (single fraction: 4-6.5 Gy). Patients without contraindications (n = 31/79.5 %) received concomitantly a cisplatin-based chemotherapy (40 mg/kg) weekly. Toxicities were graded according to the common terminology criteria for adverse events (CTCAE v 4.0).

resultsMean overall survival for the entire cohort was 61.1 months (±3.5 months). Mean disease free survival was 47.2 months (±4.9 months) and loco-regional disease free survival was 55.2 months (±4.4 months). 65 % of patients developed radiotherapy associated acute toxicities grade 1, ca. 30 % developed toxicities grade 2 and just two (5.2 %) patients developed grade 3 toxicities, one acute diarrhea and one acute cystitis. 16 % of patients had chronic toxicities grade 1, 9 % grade 2 and one patient (2.6 %) toxicities grade 3 in the form of vaginal dryness.

conclusionDose escalated IMRT appears to have a satisfactory outcome with regards to mean overall survival, disease free and loco-regional disease free survival, whereas the treatment-related toxicities remain reasonably low.

Indexed as

AdultAgedAged, 80 and overAntineoplastic AgentsBrachytherapyCarcinomaChemoradiotherapyCisplatinDisease-Free SurvivalFemaleHumansKaplan-Meier EstimateMiddle AgedRadiotherapy DosageRadiotherapy, Intensity-ModulatedRetrospective StudiesAntineoplastic AgentsCisplatin

Identifiers

PMID26597282
PMCPMC4657246

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.