{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:41:13Z","timestamp":1793036473846,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Clin Oncol"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1007\/s10147-026-03191-z","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T18:25:01Z","timestamp":1788632701000},"page":"2794-2802","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gastrointestinal perforation associated with bevacizumab and palliative radiotherapy"],"prefix":"10.1007","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2219-6708","authenticated-orcid":false,"given":"Kenji","family":"Makita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Hiroshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenari","family":"Hirata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Wakabayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saori","family":"Mishima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihito","family":"Kawazoe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadamoto","family":"Zenda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"issue":"3","key":"3191_CR1","first-page":"229","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F et al (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 74(3):229\u2013263","journal-title":"CA Cancer J Clin"},{"issue":"5","key":"3191_CR2","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1016\/j.ijrobp.2024.01.010","volume":"118","author":"SK Jabbour","year":"2024","unstructured":"Jabbour SK et al (2024) Combinatorial approaches for chemotherapies and targeted therapies with radiation: united efforts to innovate in patient care. Int J Radiat Oncol Biol Phys 118(5):1240\u20131261","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"3191_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.21873\/anticanres.14746","volume":"41","author":"KS Rallis","year":"2021","unstructured":"Rallis KS, Lai TH, Yau, Sideris M (2021) Chemoradiotherapy in cancer treatment: rationale and clinical applications. Anticancer Res 41(1):1\u20137","journal-title":"Anticancer Res"},{"issue":"1","key":"3191_CR4","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1038\/s41392-022-01102-y","volume":"7","author":"Z Zhang","year":"2022","unstructured":"Zhang Z et al (2022) Radiotherapy combined with immunotherapy: the dawn of cancer treatment. Signal Transduct Target Ther 7(1):258","journal-title":"Signal Transduct Target Ther"},{"issue":"4","key":"3191_CR5","doi-asserted-by":"publisher","first-page":"101741","DOI":"10.1016\/j.adro.2025.101741","volume":"10","author":"G Harris","year":"2025","unstructured":"Harris G et al (2025) Prospective study of patients treated with palliative radiation therapy while on immunotherapy. Adv Radiat Oncol 10(4):101741","journal-title":"Adv Radiat Oncol"},{"issue":"4","key":"3191_CR6","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1093\/jrr\/rraa035","volume":"61","author":"Y Murakami","year":"2020","unstructured":"Murakami Y et al (2020) Risk factors for severe gastrointestinal toxicity in patients receiving palliative radiotherapy for metastatic bone tumors: association with the use of molecular-targeted agents. J Radiat Res 61(4):629\u2013634","journal-title":"J Radiat Res"},{"issue":"1","key":"3191_CR7","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1158\/1078-0432.CCR-22-1366","volume":"29","author":"SA Patel","year":"2023","unstructured":"Patel SA et al (2023) Molecular mechanisms and future implications of VEGF\/VEGFR in cancer therapy. Clin Cancer Res 29(1):30\u201339","journal-title":"Clin Cancer Res"},{"issue":"1","key":"3191_CR8","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.annonc.2022.10.003","volume":"34","author":"A Cervantes","year":"2023","unstructured":"Cervantes A et al (2023) Metastatic colorectal cancer: ESMO Clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol 34(1):10\u201332","journal-title":"Ann Oncol"},{"issue":"1","key":"3191_CR9","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/S1470-2045(12)70477-1","volume":"14","author":"J Bennouna","year":"2013","unstructured":"Bennouna J et al (2013) Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised phase 3 trial. Lancet Oncol 14(1):29\u201337","journal-title":"Lancet Oncol"},{"issue":"4","key":"3191_CR10","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1093\/annonc\/mdv012","volume":"26","author":"G Masi","year":"2015","unstructured":"Masi G et al (2015) Continuation or reintroduction of bevacizumab beyond progression to first-line therapy in metastatic colorectal cancer: final results of the randomized BEBYP trial. Ann Oncol 26(4):724\u2013730","journal-title":"Ann Oncol"},{"issue":"6","key":"3191_CR11","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1016\/S1470-2045(09)70112-3","volume":"10","author":"S Hapani","year":"2009","unstructured":"Hapani S, Chu D, Wu S (2009) Risk of gastrointestinal perforation in patients with cancer treated with bevacizumab: a meta-analysis. Lancet Oncol 10(6):559\u2013568","journal-title":"Lancet Oncol"},{"issue":"6","key":"3191_CR12","doi-asserted-by":"publisher","first-page":"101022","DOI":"10.1016\/j.adro.2022.101022","volume":"7","author":"E Guimond","year":"2022","unstructured":"Guimond E et al (2022) Safety and tolerability of metastasis-directed radiation therapy in the era of evolving systemic, immune, and targeted therapies. Adv Radiat Oncol 7(6):101022","journal-title":"Adv Radiat Oncol"},{"issue":"3","key":"3191_CR13","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1038\/bmt.2012.244","volume":"48","author":"Y Kanda","year":"2013","unstructured":"Kanda Y (2013) Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics. Bone Marrow Transpl 48(3):452\u2013458","journal-title":"Bone Marrow Transpl"},{"issue":"1","key":"3191_CR14","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1186\/s12957-023-03058-x","volume":"21","author":"MH Storandt","year":"2023","unstructured":"Storandt MH et al (2023) Gastrointestinal perforation after bevacizumab: a multi-site, single-institution study with a focus on survival. World J Surg Oncol 21(1):177","journal-title":"World J Surg Oncol"},{"issue":"6","key":"3191_CR15","doi-asserted-by":"publisher","first-page":"1860","DOI":"10.1245\/s10434-006-9337-9","volume":"14","author":"MW Saif","year":"2007","unstructured":"Saif MW, Elfiky A, Salem RR (2007) Gastrointestinal perforation due to bevacizumab in colorectal cancer. Ann Surg Oncol 14(6):1860\u20131869","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"3191_CR16","first-page":"e1952","volume":"7","author":"K Fang","year":"2024","unstructured":"Fang K et al (2024) Gastrointestinal perforation associated with bevacizumab in metastatic colorectal cancer. Cancer Rep (Hoboken) 7(2):e1952","journal-title":"Cancer Rep (Hoboken)"},{"key":"3191_CR17","doi-asserted-by":"publisher","first-page":"3535","DOI":"10.1200\/jco.2006.24.18_suppl.3535","volume":"24","author":"M Sugrue","year":"2006","unstructured":"Sugrue M, Hainsworth MKJ, Badarinath S, Cohn A, Flynn P, Steis R, Dong W, Sarkar S, GrotheyAuthors A (2006) Risk factors for gastrointestinal perforations in patients with metastatic colorectal cancer receiving bevacizumab plus chemotherapy. J Clin Oncol 24:3535","journal-title":"J Clin Oncol"},{"key":"3191_CR18","doi-asserted-by":"crossref","unstructured":"Wichelmann TAA, Ehrenpreis S, Eli D (2020) , Exploring the link between bevacizumab and gastrointestinal perforations using the FDa adverse event reporting system database. American J Gastroenterol S68","DOI":"10.14309\/01.ajg.0000702992.19834.54"},{"issue":"3","key":"3191_CR19","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.radonc.2018.01.003","volume":"126","author":"SE Rich","year":"2018","unstructured":"Rich SE et al (2018) Update of the systematic review of palliative radiation therapy fractionation for bone metastases. Radiother Oncol 126(3):547\u2013557","journal-title":"Radiother Oncol"},{"issue":"11","key":"3191_CR20","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1200\/JCO.2006.09.5281","volume":"25","author":"E Chow","year":"2007","unstructured":"Chow E et al (2007) Palliative radiotherapy trials for bone metastases: a systematic review. J Clin Oncol 25(11):1423\u20131436","journal-title":"J Clin Oncol"},{"issue":"11","key":"3191_CR21","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1093\/jnci\/dji139","volume":"97","author":"WF Hartsell","year":"2005","unstructured":"Hartsell WF et al (2005) Randomized trial of short- versus long-course radiotherapy for palliation of painful bone metastases. J Natl Cancer Inst 97(11):798\u2013804","journal-title":"J Natl Cancer Inst"},{"issue":"1","key":"3191_CR22","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1002\/ijgo.15609","volume":"167","author":"ST Yang","year":"2024","unstructured":"Yang ST et al (2024) Bevacizumab is associated with a higher gastrointestinal\/genitourinary fistula or perforation risk in cervical cancer patients undergoing pelvic radiotherapy. Int J Gynaecol Obstet 167(1):80\u201387","journal-title":"Int J Gynaecol Obstet"},{"issue":"12","key":"3191_CR23","doi-asserted-by":"publisher","first-page":"110621","DOI":"10.4251\/wjgo.v17.i12.110621","volume":"17","author":"WM He","year":"2025","unstructured":"He WM, Li WS (2025) Investigating radiotherapy\u2019s impact on intestinal perforation risk in gastrointestinal tumor patients treated with bevacizumab. World J Gastrointest Oncol 17(12):110621","journal-title":"World J Gastrointest Oncol"},{"issue":"3","key":"3191_CR24","doi-asserted-by":"publisher","first-page":"e121","DOI":"10.1016\/S1470-2045(22)00752-5","volume":"24","author":"SGC Kroeze","year":"2023","unstructured":"Kroeze SGC et al (2023) Metastases-directed stereotactic body radiotherapy in combination with targeted therapy or immunotherapy: systematic review and consensus recommendations by the EORTC-ESTRO OligoCare consortium. Lancet Oncol 24(3):e121\u2013e132","journal-title":"Lancet Oncol"},{"issue":"1","key":"3191_CR25","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.annonc.2025.09.008","volume":"37","author":"ESM van Aken","year":"2026","unstructured":"van Aken ESM et al (2026) ESMO-ESTRO consensus statements on the safety of combining radiotherapy with immune checkpoint inhibitors, VEGF(R) inhibitors, or multitargeted tyrosine kinase inhibitors. Ann Oncol 37(1):17\u201332","journal-title":"Ann Oncol"}],"container-title":["International Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10147-026-03191-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10147-026-03191-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10147-026-03191-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:04:08Z","timestamp":1793034248000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10147-026-03191-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,5]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["3191"],"URL":"https:\/\/doi.org\/10.1007\/s10147-026-03191-z","relation":{},"ISSN":["1341-9625","1437-7772"],"issn-type":[{"value":"1341-9625","type":"print"},{"value":"1437-7772","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,5]]},"assertion":[{"value":"31 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"AK reports grants from AstraZeneca and MSD; consulting fees from Zymeworks, MSD, Revolution Medicines, and Abbvie; honoraria from Taiho Pharmaceutical, Bristol Myers Squibb (BMS), Merck Serono, Ono, and Daiichi Sankyo; support for attending meetings or travel from Ono and MSD; and participation on an advisory board in Abbvie. MN reports receiving honoraria from AstraZeneca, Illumina, and Sumitomo Heavy Industries. All other authors declare that they have no conflict of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in this study were in accordance with the ethical standards of the Institutional Research Committee and the 1964 Declaration of Helsinki and its later amendments.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Patients treated at National Cancer Center Japan Hospital East consented for the use of their anonymous data for research.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}