| dc.contributor.advisor | Wolff, Hendrik PD Dr. | |
| dc.contributor.author | von Sivers, Franziska-Felicitas | |
| dc.date.accessioned | 2020-08-24T10:36:11Z | |
| dc.date.available | 2020-08-24T10:36:11Z | |
| dc.date.issued | 2020-08-24 | |
| dc.identifier.uri | http://hdl.handle.net/21.11130/00-1735-0000-0005-1465-3 | |
| dc.identifier.uri | http://dx.doi.org/10.53846/goediss-8170 | |
| dc.language.iso | deu | de |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
| dc.subject.ddc | 610 | de |
| dc.title | Radio(chemo)therapie des Zervixkarzinoms – Klinische Ergebnisse mit intensitätsmodulierter Rotationsbestrahlung und konventioneller 3D-Bestrahlung im Vergleich | de |
| dc.type | doctoralThesis | de |
| dc.title.translated | radiochemptherapy of cervical carcinoma - outcome and toxicity in volumetric modulated arc therapy and 3-dimensional radiotherapy in comparison | de |
| dc.contributor.referee | Bauerschmitz, Gerd-Johannes PD Dr. | |
| dc.date.examination | 2020-07-07 | |
| dc.description.abstractger | Die R(C)T des ZKs wurde bis 2009 in der Klinik für Strahlentherapie und
Radioonkologie der Universitätsmedizin Göttingen (UMG) mittels konventioneller 3DRT durchgeführt. Seit 2009 wurde diese Technik weitgehend durch IMRT und VMAT
abgelöst. Anhand der retrospektiven Analyse der klinischen Daten der Patientinnen
wird in dieser Untersuchung geprüft, ob durch die neueren RT-Techniken,- mit besserer
Kongruenz der Dosisverteilung und des Zielvolumens („Konformität“), sowie
verbesserter Aussparung der OAR- auf klinischer Ebene eine Verbesserung des
Therapieerfolgs oder eine Reduktion der Nebenwirkungsraten erreicht werden kann.
Zusätzlich wird geprüft, ob weitere patientenspezifische oder therapieassoziierte
Faktoren die Nebenwirkungsraten beeinflussen. | de |
| dc.description.abstracteng | Abstract
Purpose
Intensity-modulated radiotherapy (IMRT) for cervical cancer yields favorable results in terms of oncological outcomes, acute toxicity, and late toxicity. Limited data are available on clinical results with volumetric modulated arc therapy (VMAT). This study’s purpose is to compare outcome and toxicity with VMAT to conventional 3D conformal radiotherapy (3DCRT), giving special consideration to the influence of patient- and treatment-related parameters on side effects.
Methods and Materials
Patients with cervical cancer stage I-IVA underwent radiotherapy alone or chemoradiotherapy using 3DCRT (n=75) or VMAT (n=30). Survival endpoints were overall survival, progression-free survival and locoregional control. The National Cancer Institute Common Terminology Criteria for Adverse Events and the Late effects of normal tissues criteria were used for toxicity assessment. Patient- and treatment-related parameters with possible influence on toxicity were included in multivariate analysis.
Results
There were no differences in survival rates between treatment groups. VMAT was associated with reduced risk of late small bowel toxicity (OR=0.10, p=0.03) and with increased risk of acute urinary toxicity (OR=2.94, p=0.01). Independent of irradiation technique, a low body mass index (OR=2.46, p=0.03) and overall acute toxicity ≥grade 2 (OR=4.17, p<0.01) were associated with increased overall late toxicity.
Conclusions
We demonstrated significant reduction of late small bowel toxicity with VMAT-treatment; an improvement in long-term morbidity is absolutely conceivable. VMAT-
treated patients suffered from acute urinary toxicity more frequently, which might be explained by an increase in low dose bath to the bladder. The avoidance of weight loss during treatment or the close monitoring of patients who experienced acute toxicity ≥grade 2 during follow-up care could represent promising interventions to improve late toxicity profiles | de |
| dc.contributor.coReferee | Oppermann, Martin Prof. Dr. | |
| dc.subject.eng | Cervical carcinoma | de |
| dc.identifier.urn | urn:nbn:de:gbv:7-21.11130/00-1735-0000-0005-1465-3-4 | |
| dc.affiliation.institute | Medizinische Fakultät | de |
| dc.subject.gokfull | Medizin (PPN619874732) | de |
| dc.subject.gokfull | MED 000 | de |
| dc.identifier.ppn | 1727708288 | |