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The aim of this prospective study was to correlate patient characteristics and dose\u2013volume parameters to various early morbidity endpoints for different EBRT techniques, including volumetric modulated arc therapy (VMAT) and adaptive radiotherapy (ART).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods and materials<\/jats:title>\n                <jats:p>The study population consisted of 48\u00a0patients diagnosed with locally advanced cervix cancer, treated with definitive radiochemotherapy including image-guided adaptive brachytherapy (IGABT). Multiple questionnaires (CTCAE 4.03, QLQ-C30 and EORTC QLQ-CX24) were assessed prospectively for patients treated with different EBRT techniques, including online adaptive VMAT. Contouring and treatment planning was based on the EMBRACE protocols. Acute toxicity, classified as general, gastrointestinal (GI) or genitourinary (GU) and their corresponding dose\u2013volume histograms (DVHs) were first correlated by applying least absolute shrinkage and selection operator (LASSO) and subsequently evaluated by multiple logistic binomial regression.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The treated EBRT volumes varied for the different techniques with ~2500\u202fcm<jats:sup>3<\/jats:sup> for 3D conformal radiotherapy (3D-CRT), ~2000\u202fcm<jats:sup>3<\/jats:sup> for EMBRACE\u2011I VMAT, and ~1800\u202fcm<jats:sup>3<\/jats:sup> for EMBRACE-II VMAT and ART. In general, a\u00a0worsening of symptoms during the first 5 treatment weeks and recovery afterwards was observed. Dose\u2013volume parameters significantly correlating with stool urgency, rectal and urinary incontinence were as follows: bowel V<jats:sub>40Gy<\/jats:sub>\u202f&lt;\u2009250\u202fcm<jats:sup>3<\/jats:sup>, rectum V<jats:sub>40Gy<\/jats:sub>\u202f&lt;\u200980% and bladder V<jats:sub>40Gy<\/jats:sub>\u202f&lt;\u200980\u201390%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This prospective study demonstrated the impact of EBRT treatment techniques in combination with chemotherapy on early morbidity. Dose\u2013volume effects for dysuria, urinary incontinence, stool urgency, diarrhea, rectal bleeding, rectal incontinence and weight loss were found.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00066-021-01781-6","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T10:03:00Z","timestamp":1619776980000},"page":"505-519","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Early morbidity and dose\u2013volume effects in definitive radiochemotherapy for locally advanced cervical cancer: a\u00a0prospective cohort study covering modern treatment techniques"],"prefix":"10.1007","volume":"197","author":[{"given":"Yvette","family":"Seppenwoolde","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarina","family":"Majercakova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Buschmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elke","family":"D\u00f6rr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina E.","family":"Sturdza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian P.","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"P\u00f6tter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietmar","family":"Georg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,4,30]]},"reference":[{"key":"1781_CR1","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/j.radonc.2018.03.003","volume":"127","author":"D Cibula","year":"2018","unstructured":"Cibula\u00a0D, P\u00f6tter\u00a0R, Planchamp\u00a0F, Avall-Lundqvist\u00a0E, Fischerova\u00a0D, Haie Meder\u00a0C et al (2018) The European society of gynaecological oncology\/European society for radiotherapy and oncology\/European society of pathology guidelines for the management of patients with cervical cancer. 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