A Phase III Randomized Trial Comparing Patient-Reported Toxicity and Quality of Life (QOL) During Pelvic Intensity Modulated Radiation Therapy as Compared to Conventional Radiation Therapy

Klopp, Ann H.; Yeung, Anamaria R.; Deshmukh, Snehal; Gil, Karen M.; Wenzel, Lari; Westin, Shannon N.; Gifford, Kent A; Gaffney, David K.; Small, William; Thompson, Spencer; Doncals, Desiree E.; Cantuaria, Guilherme; Yaremko, Brian; Chang, Amy; Kundapur, Vijayananda; Mohan, Dasarahally S.; Haas, Michael L.; Kim, Y.B.; Ferguson, C.L.; Bruner, Deborah Watkins

doi:10.1016/j.ijrobp.2016.06.024

Cited by 42 publications

(30 citation statements)

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“…Recent advances in EBRT techniques include the use of highly conformal techniques (such as IMRT) that allow for greater normal tissue sparing. Radiation Therapy Oncology Group 1203 (TIME‐C; ClinicalTrials.gov identifier NCT01672892) is a randomized trial of standard RT techniques versus IMRT in the postoperative setting for patients with either cervical or endometrial cancer; preliminary results suggest that IMRT is associated with improved acute GI and genitourinary toxicity using a variety of patient‐reported measures . The reported time point was at 5 weeks after the initiation of RT, at the expected peak of RT‐related toxicity; longer follow‐up is needed to determine whether IMRT is also associated with improved late toxicity measures.…”

Section: Adjuvant Therapymentioning

confidence: 99%

“…Radiation Therapy Oncology Group 1203 (TIME-C; ClinicalTrials.gov identifier NCT01672892) is a randomized trial of standard RT techniques versus IMRT in the postoperative setting for patients with either cervical or endometrial cancer; preliminary results suggest that IMRT is associated with improved acute GI and genitourinary toxicity using a variety of patient-reported measures. 109 The reported time point was at 5 weeks after the initiation of RT, at the expected peak of RT-related toxicity; longer follow-up is needed to determine whether IMRT is gov identifier NCT01279135) from India is also accruing patients for randomization to either a postoperative standard RT technique versus IMRT, although this is only in patients with cervical cancer. An interim analysis reported no different in acute GI toxicity using physician-reported outcomes.…”

Section: High-risk Diseasementioning

confidence: 99%

“…The Nordic Society for Gynecologic Oncology (NSGO)-9501/European Organization for Research and Treatment of Cancer (EORTC)-55991 and Mario Negri Gynecologic Oncology Group (MaNGO)/ILIADE-III studies investigated the sequential administration of EBRT before or after chemotherapy compared with EBRT alone. 109 In the EORTC study, chemotherapy consisted of either 4 cycles of doxorubicin (50 mg/m 2 ) plus cisplatin (50 mg/m 2 ; the AP regimen), doxorubicin plus carboplatin, epirubicin plus cisplatin, epirubicin plus paclitaxel, or carboplatin plus paclitaxel. Use of VBT was a stratification factor.…”

Section: Addition Of Chemotherapy To Rtmentioning

confidence: 99%

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Current recommendations and recent progress in endometrial cancer

Brooks

Fleming

Lastra

et al. 2019

CA A Cancer J Clinicians

457

372

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Endometrial cancer is the most common gynecologic cancer in the United States, and its incidence is rising. Although there have been significant recent advances in our understanding of endometrial cancer biology, many aspects of treatment remain mired in controversy, including the role of surgical lymph node assessment and the selection of patients for adjuvant radiation or chemotherapy. For the subset of women with microsatellite‐instable, metastatic disease, anti– programmed cell death protein 1 immunotherapy (pembrolizumab) is now approved by the US Food and Drug Administration, and numerous trials are attempting to build on this early success.

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Section: Adjuvant Therapymentioning

confidence: 99%

Section: High-risk Diseasementioning

confidence: 99%

Section: Addition Of Chemotherapy To Rtmentioning

confidence: 99%

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Current recommendations and recent progress in endometrial cancer

Brooks

Fleming

Lastra

et al. 2019

CA A Cancer J Clinicians

457

372

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“…Additionally, phase 3 randomized trials comparing postoperative 3-dimensional conformal RT (3D-CRT) versus IMRT have been performed for cervical cancer in India 7 and for cervical or endometrial cancer in a multinational setting 8 . Preliminary data from these studies also suggest reduced acute or late toxicity with IMRT.…”

Section: Introductionmentioning

confidence: 99%

Intensity modulated radiation therapy for squamous cell carcinoma of the vulva: Treatment technique and outcomes

Rao

Chundury

Schwarz

et al. 2017

Advances in Radiation Oncology

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ObjectiveThe objective of this study was to present the treatment technique and evaluate clinical outcomes after intensity modulated radiation therapy (IMRT) for vulvar cancer.Methods and materialsThis retrospective study included 39 patients with squamous cell carcinoma of the vulva treated with IMRT from 2005 to 2015. There were 21 patients treated with postoperative IMRT, 13 with definitive IMRT, and 5 with preoperative IMRT. Tumor staging was Federation of Gynecology and Obstetrics stage I in 6, stage II in 7, stage III in 19, and stage IV in 7 patients. Concurrent chemotherapy was administered to 14 patients. Brachytherapy was delivered in 8 patients.ResultsThe median follow-up was 34 months (range, 3.3-71). Median IMRT dose to patients receiving pre- or postoperative IMRT was 5040 cGy (range, 5040-6080). Median combined IMRT and brachytherapy dose to gross tumor was 7000 cGy (range, 5040-7520) in those treated with definitive RT. The 3-year locoregional control (LRC) and overall survival for those receiving postoperative RT were 89% and 67%, respectively. The 3-year LRC and overall survival for those receiving definitive IMRT were 42% and 49%, respectively. In patients receiving definitive or neoadjuvant IMRT, 69% had complete clinical response and 44% had complete pathologic response. The actuarial 3-year inguinal recurrence rate was 7%. There were no acute grade 3-4 hematological, gastrointestinal, or genitourinary toxicities. There were no late grade 3-4 gastrointestinal or genitourinary toxicities.ConclusionsIMRT for vulvar cancer is associated with high rates of LRC in the postoperative setting and limited radiation-related toxicity. Durable LRC of disease after definitive IMRT remains challenging, and several refinements to our treatment technique are suggested.

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“…3 In addition, welldesigned retrospective studies evaluating highly conformal techniques such as intensity-modulated RT have been published. 4 It has even been demonstrated that even higher external beam RT doses applied to metastatic lymph nodes result in acceptable short-term and chronic toxicity.…”

Section: In Regard To Derks Et Al Type Of Radiotherapy Is Important Fmentioning

confidence: 99%