{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:51:35Z","timestamp":1786981895129,"version":"build-2736575974"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005743","name":"Universit\u00e0 Cattolica del Sacro Cuore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005743","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiol med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vulvar carcinoma is a rather uncommon gynecological malignancy affecting elderly women and the treatment of loco-regional advanced carcinoma of the vulva (LAVC) is a challenge for both gynecologic and radiation oncologists. Definitive chemoradiation (CRT) is the treatment of choice, but with disappointing results. In this multicenter study (OLDLADY-1.1), several institutions have combined their retrospective data on LAVC patients to produce a real-world dataset aimed at collecting data on efficacy and safety of CRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The primary study end-point was 2-year-local control (LC), secondary end-points were 2-year-metastasis free-survival (MFS), 2-year-overall survival (OS) and the rate and severity of acute and late toxicities. Participating centers were required to fill data sets including age, stage, histology, grading as well as technical\/dosimetric details of CRT. Data about response, local and regional recurrence, acute and late toxicities, follow-up and outcome measures were also collected. The toxicity was a posteriori documented through the Common Terminology Criteria for Adverse Events version 5 scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Retrospective analysis was performed on 65 patients with primary or recurrent LAVC treated at five different radiation oncology institutions covering 11-year time interval (February 2010\u2013November 2021). Median age at diagnosis was 72\u00a0years (range 32\u201389). With a median follow-up of 19\u00a0months (range 1\u2013114\u00a0months), 2-year actuarial LC, MFS and OS rate were 43.2%, 84.9% and 59.7%, respectively. In 29 patients (44%), CRT was temporarily stopped (median 5\u00a0days, range 1\u201353\u00a0days) due to toxicity. The treatment interruption was statistically significant at univariate analysis of factors predicting LC (\n                      <jats:italic>p<\/jats:italic>\n                      : 0.05) and OS rate (\n                      <jats:italic>p<\/jats:italic>\n                      : 0.011), and it was confirmed at the multivariate analysis for LC rate (\n                      <jats:italic>p<\/jats:italic>\n                      : 0.032). In terms of toxicity profile, no G4 event was recorded. Most adverse events were reported as grade 1 or 2. Only 14 acute G3 toxicities, all cutaneous, and 7 late G3 events (3 genitourinary, 3 cutaneous, and 1 vaginal stenosis) were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the context of CRT for LAVC, the present study reports encouraging results even if there is clearly room for further improvements, in terms of both treatment outcomes, toxicity and treatment interruption management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11547-023-01712-8","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T13:01:37Z","timestamp":1694523697000},"page":"152-159","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Definitive chemoradiation in vulvar squamous cell carcinoma: outcome and toxicity from an observational multicenter Italian study on vulvar cancer (OLDLADY 1.1)"],"prefix":"10.1007","volume":"129","author":[{"given":"Gabriella","family":"Macchia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3507-7051","authenticated-orcid":false,"given":"Valentina","family":"Lancellotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Ferioli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calogero","family":"Cas\u00e0","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donato","family":"Pezzulla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigida","family":"Pappalardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Laliscia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edy","family":"Ippolito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Di Muzio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Huscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Tortoreto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Boccardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Lazzari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Myriam","family":"Perrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Raspagliesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angiolo","family":"Gadducci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Garganese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona Maria","family":"Fragomeni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Ferrandina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio Giuseppe","family":"Morganti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Antonietta","family":"Gambacorta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Tagliaferri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"1712_CR1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21590","volume":"70","author":"RL Siegel","year":"2020","unstructured":"Siegel RL, Miller KD, Jemal A (2020) Cancer statistics, 2020. CA A Cancer J Clin 70:7\u201330. https:\/\/doi.org\/10.3322\/caac.21590","journal-title":"CA A Cancer J Clin"},{"key":"1712_CR2","first-page":"1311","volume-title":"Cancer: principles and practice of oncology","year":"2011","unstructured":"Vincent T, Lawrence TS, Rosenberg SA (eds) (2011) Cancer: principles and practice of oncology, 9th edn. Wolters Kluwer Health\/ Lippincott Williams & Wilkins, Philadelphia, pp 1311\u20131344","edition":"9"},{"key":"1712_CR3","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1097\/IGC.0000000000000975","volume":"27","author":"MHM Oonk","year":"2017","unstructured":"Oonk MHM, Planchamp F, Baldwin P et al (2017) European society of gynaecological oncology guidelines for the management of patients with vulvar cancer. Int J Gynecol Cancer 27:832\u2013837. https:\/\/doi.org\/10.1097\/IGC.0000000000000975","journal-title":"Int J Gynecol Cancer"},{"key":"1712_CR4","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1006\/gyno.2001.6266","volume":"82","author":"N Gould","year":"2001","unstructured":"Gould N, Kamelle S, Tillmanns T, Scribner D, Gold M, Walker J et al (2001) Predictors of complications after inguinal lymphadenectomy. Gynecol Oncol 82:329\u2013332. https:\/\/doi.org\/10.1006\/gyno.2001.6266","journal-title":"Gynecol Oncol"},{"key":"1712_CR5","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.ygyno.2015.09.077","volume":"140","author":"NC Te Grootenhuis","year":"2016","unstructured":"Te Grootenhuis NC, van der Zee AG, van Doorn HC et al (2016) Sentinel nodes in vulvar cancer: long-term follow-up of the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) I. Gynecol Oncol 140:8\u201314. https:\/\/doi.org\/10.1016\/j.ygyno.2015.09.077","journal-title":"Gynecol Oncol"},{"key":"1712_CR6","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1097\/IGC.0000000000000938","volume":"27","author":"D Natesan","year":"2017","unstructured":"Natesan D, Hong JC, Foote J, Sosa JA, Havrilesky L, Chino J (2017) Primary versus preoperative radiation for locally advanced vulvar cancer. Int J Gynecol Cancer 27:794\u2013804. https:\/\/doi.org\/10.1097\/IGC.0000000000000938","journal-title":"Int J Gynecol Cancer"},{"key":"1712_CR7","doi-asserted-by":"publisher","first-page":"307","DOI":"10.21873\/invivo.11775","volume":"34","author":"Y Mukai","year":"2020","unstructured":"Mukai Y, Koike I, Matsunaga T et al (2020) Outcome of radiation therapy for locally advanced vulvar carcinoma: analysis of inguinal lymph node. In Vivo 34:307\u2013313. https:\/\/doi.org\/10.21873\/invivo.11775","journal-title":"In Vivo"},{"key":"1712_CR8","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1016\/s0360-3016(00)00569-1","volume":"47","author":"H Huang","year":"2000","unstructured":"Huang H, Feng YL, Wan T et al (2000) Chemoradiation as primary or adjuvant treatment for locally advanced carcinoma of the vulva. Int J Radiat Oncol Biol Phys 47:1235\u20131244. https:\/\/doi.org\/10.1016\/s0360-3016(00)00569-1","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"1712_CR9","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1515\/raon-2017-0024","volume":"51","author":"HBZ Logar","year":"2017","unstructured":"Logar HBZ (2017) Long term results of radiotherapy in vulvar cancer patients in Slovenia between 1997\u20132004. Radiol Oncol 51:447\u2013454. https:\/\/doi.org\/10.1515\/raon-2017-0024","journal-title":"Radiol Oncol"},{"key":"1712_CR10","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1097\/AOG.0b013e3181b12f99","volume":"114","author":"C Kunos","year":"2009","unstructured":"Kunos C, Simpkins F, Gibbons H et al (2009) Radiation therapy compared with pelvic node resection for node positive vulvar cancer: a randomized controlled trial. Obstet Gynecol 114:537\u2013546. https:\/\/doi.org\/10.1097\/AOG.0b013e3181b12f99","journal-title":"Obstet Gynecol"},{"key":"1712_CR11","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.adro.2017.02.006","volume":"2","author":"YJ Rao","year":"2017","unstructured":"Rao YJ, Chundury A, Schwarz JK et al (2017) Intensity modulated radiation therapy for squamous cell carcinoma of the vulva: treatment technique and outcomes. Adv Radiat Oncol 2:148\u2013158. https:\/\/doi.org\/10.1016\/j.adro.2017.02.006","journal-title":"Adv Radiat Oncol"},{"key":"1712_CR12","doi-asserted-by":"publisher","first-page":"5747","DOI":"10.3390\/cancers13225747","volume":"13","author":"L Tagliaferri","year":"2021","unstructured":"Tagliaferri L, Lancellotta V, Cas\u00e0 C et al (2021) The radiotherapy role in the multidisciplinary management of locally advanced vulvar cancer: a multidisciplinary Vulcan team review. Cancers (Basel) 13:5747. https:\/\/doi.org\/10.3390\/cancers13225747","journal-title":"Cancers (Basel)"},{"key":"1712_CR13","doi-asserted-by":"publisher","first-page":"368","DOI":"10.3857\/roj.2017.00227","volume":"35","author":"K Sakanaka","year":"2017","unstructured":"Sakanaka K, Itasaka S, Ishida Y et al (2017) Dosimetric advantages and clinical outcomes of simultaneous integrated boost intensity-modulated radiotherapy for anal squamous cell carcinoma. Radiat Oncol J 35:368\u2013379. https:\/\/doi.org\/10.3857\/roj.2017.00227","journal-title":"Radiat Oncol J"},{"key":"1712_CR14","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/j.ygyno.2019.11.027","volume":"156","author":"A Rishi","year":"2020","unstructured":"Rishi A, Rollins M, Ahmed KA et al (2020) High-dose intensity-modulated chemoradiotherapy in vulvar squamous cell carcinoma: outcome and toxicity. Gynecol Oncol 156:349\u2013356. https:\/\/doi.org\/10.1016\/j.ygyno.2019.11.027","journal-title":"Gynecol Oncol"},{"key":"1712_CR15","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1016\/j.ygyno.2020.09.019","volume":"159","author":"AH Richman","year":"2020","unstructured":"Richman AH, Vargo JA, Ling DC et al (2020) Dose-escalated intensity modulated radiation therapy in patients with locally-advanced vulvar cancer - does it increase response rate? Gynecol Oncol 159:657\u2013662. https:\/\/doi.org\/10.1016\/j.ygyno.2020.09.019","journal-title":"Gynecol Oncol"},{"issue":"11","key":"1712_CR16","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.1007\/s11547-022-01538-w","volume":"127","author":"G Macchia","year":"2022","unstructured":"Macchia G, Cas\u00e0 C, Ferioli M, Lancellotta V, Pezzulla D, Pappalardi B, Laliscia C, Ippolito E, Di Muzio J, Huscher A, Tortoreto F, Boccardi M, Lazzari R, De Iaco P, Raspagliesi F, Gadducci A, Garganese G, Ferrandina G, Morganti AG, Tagliaferri L (2022) Observational multicenter Italian study on vulvar cancer adjuvant radiotherapy (OLDLADY 1.2): a cooperation among AIRO Gyn, MITO and MaNGO groups. Radiol Med 127(11):1292\u20131302","journal-title":"Radiol Med"},{"key":"1712_CR17","unstructured":"Common Terminology Criteria for Adverse Events (CTCAE) Version 5. Published: November 27. US Department of Health and Human Services, National Institutes of Health, National Cancer Institute"},{"key":"1712_CR18","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.ygyno.2021.07.020","volume":"163","author":"B van Triest","year":"2021","unstructured":"van Triest B, Rasing M, van der Velden J et al (2021) Phase II study of definitive chemoradiation for locally advanced squamous cell cancer of the vulva: an efficacy study. Gynecol Oncol 163:117\u2013124. https:\/\/doi.org\/10.1016\/j.ygyno.2021.07.020","journal-title":"Gynecol Oncol"},{"key":"1712_CR19","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/j.ygyno.2017.06.022","volume":"146","author":"YJ Rao","year":"2017","unstructured":"Rao YJ, Chin RI, Hui C et al (2017) Improved survival with definitive chemoradiation compared to definitive radiation alone in squamous cell carcinoma of the vulva: a review of the National Cancer Database. Gynecol Oncol 146:572\u2013579. https:\/\/doi.org\/10.1016\/j.ygyno.2017.06.022","journal-title":"Gynecol Oncol"},{"key":"1712_CR20","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1016\/s0039-6257(01)00188-6","volume":"47","author":"SC Han","year":"2000","unstructured":"Han SC, Kim DH, Higgins SA, Carcangiu ML, Kacinski BM (2000) Chemoradiation as primary or adjuvant treatment for locally advanced carcinoma of the vulva. Int J Radiat Oncol 47:1235\u20131244. https:\/\/doi.org\/10.1016\/s0039-6257(01)00188-6","journal-title":"Int J Radiat Oncol"},{"key":"1712_CR21","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.ygyno.2007.11.010","volume":"108","author":"LM Landrum","year":"2008","unstructured":"Landrum LM, Skaggs V, Gould N, Walker JL, McMeekin DS (2008) Comparison of outcome measures in patients with advanced squamous cell carcinoma of the vulva treated with surgery or primary chemoradiation. Gynecol Oncol 108:584\u2013590. https:\/\/doi.org\/10.1016\/j.ygyno.2007.11.010","journal-title":"Gynecol Oncol"},{"issue":"4","key":"1712_CR22","doi-asserted-by":"publisher","first-page":"003752","DOI":"10.1002\/14651858.CD003752.pub3","volume":"2011","author":"TS Shylasree","year":"2011","unstructured":"Shylasree TS, Bryant A, Howells RE (2011) Chemoradiation for advanced primary vulvar cancer. Cochr Database Syst. Rev 2011(4):003752. https:\/\/doi.org\/10.1002\/14651858.CD003752.pub3","journal-title":"Cochr Database Syst. Rev"},{"key":"1712_CR23","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/j.ygyno.2011.11.003","volume":"124","author":"DH Moore","year":"2012","unstructured":"Moore DH, Ali S, Koh WJ et al (2012) A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: a gynecologic oncology group study. Gynecol Oncol 124:529\u2013533. https:\/\/doi.org\/10.1016\/j.ygyno.2011.11.003","journal-title":"Gynecol Oncol"},{"key":"1712_CR24","doi-asserted-by":"publisher","first-page":"2535","DOI":"10.1007\/s00432-020-03312-9","volume":"146","author":"G Garganese","year":"2020","unstructured":"Garganese G, Tagliaferri L, Fragomeni SM et al (2020) Personalizing vulvar cancer workflow in COVID-19 era: a proposal from Vul. Can MDT. J Cancer Res Clin Oncol 146:2535\u20132545. https:\/\/doi.org\/10.1007\/s00432-020-03312-9","journal-title":"J Cancer Res Clin Oncol"},{"key":"1712_CR25","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1136\/ijgc-2020-001465","volume":"30","author":"L Tagliaferri","year":"2020","unstructured":"Tagliaferri L, Garganese G, D\u2019Aviero A et al (2020) Muldisciplinary personalized approach in the management of vulvar cancer-the Vul. Can Team Experience. Int J Gynecol Cancer 30:932\u2013938. https:\/\/doi.org\/10.1136\/ijgc-2020-001465","journal-title":"Int J Gynecol Cancer"},{"key":"1712_CR26","doi-asserted-by":"publisher","first-page":"3852","DOI":"10.3390\/cancers14163852","volume":"14","author":"M Micc\u00f2","year":"2022","unstructured":"Micc\u00f2 M, Russo L, Persiani S et al (2022) MRI in the evaluation of locally advanced vulvar cancer treated with chemoradiotherapy and vulvar cancer recurrence: the 2021 revision of FIGO classification and the need for multidisciplinary management. Cancers (Basel) 14:3852. https:\/\/doi.org\/10.3390\/cancers14163852","journal-title":"Cancers (Basel)"},{"key":"1712_CR27","doi-asserted-by":"publisher","first-page":"192","DOI":"10.5505\/tjo.2022.2819","volume":"37","author":"R Iezzi","year":"2022","unstructured":"Iezzi R, Fionda B, Cornacchione P et al (2022) Can a dedicated multidisciplinary tumor board improve personalized medicine for patients in interventional oncology? A large retrospective single-center experience. Turk J Oncol 37:192\u2013199. https:\/\/doi.org\/10.5505\/tjo.2022.2819","journal-title":"Turk J Oncol"},{"key":"1712_CR28","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/S0140-6736(06)69121-6","volume":"368","author":"J Bourhis","year":"2006","unstructured":"Bourhis J, Overgaard J, Audry H et al (2006) Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis. Lancet 368:843\u2013854. https:\/\/doi.org\/10.1016\/S0140-6736(06)69121-6","journal-title":"Lancet"},{"key":"1712_CR29","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.radonc.2016.05.014","volume":"120","author":"K Tanderup","year":"2016","unstructured":"Tanderup K, Fokdal LU, Sturdza A et al (2016) Effect of tumor dose, volume and overall treatment time on local control after radiochemotherapy including MRI guided brachytherapy of locally advanced cervical cancer. Radiother Oncol 120:441\u2013446. https:\/\/doi.org\/10.1016\/j.radonc.2016.05.014","journal-title":"Radiother Oncol"},{"key":"1712_CR30","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/j.ygyno.2018.01.007","volume":"148","author":"SR Stecklein","year":"2018","unstructured":"Stecklein SR, Frumovitz M, Klopp AH et al (2018) Effectiveness of definitive radiotherapy for squamous cell carcinoma of the vulva with gross inguinal lymphadenopathy. Gynecol Oncol 148:474\u2013479. https:\/\/doi.org\/10.1016\/j.ygyno.2018.01.007","journal-title":"Gynecol Oncol"},{"key":"1712_CR31","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1136\/ijgc-2019-000526","volume":"30","author":"I Zapardiel","year":"2020","unstructured":"Zapardiel I, Iacoponi S, Coronado PJ et al (2020) Prognostic factors in patients with vulvar cancer: the VULCAN study. Int J Gynecol Cancer 30:1285\u20131291","journal-title":"Int J Gynecol Cancer"},{"key":"1712_CR32","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1046\/j.1525-1438.2003.13304.x","volume":"13","author":"KN Gaarenstroom","year":"2003","unstructured":"Gaarenstroom KN, Kenter GG, Trimbos JB et al (2003) Postoperative complications after vulvectomy and inguinofemoral lymphadenectomy using separate groin incisions. Int J Gynecol Cancer 13:522\u2013527. https:\/\/doi.org\/10.1046\/j.1525-1438.2003.13304.x","journal-title":"Int J Gynecol Cancer"},{"key":"1712_CR33","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.ygyno.2018.08.002","volume":"151","author":"ZD Horne","year":"2018","unstructured":"Horne ZD, Dohopolski MJ, Pradhan D et al (2018) Human papillomavirus infection mediates response and outcome of vulvar squamous cell carcinomas treated with radiation therapy. Gynecol Oncol 151:96\u2013101. https:\/\/doi.org\/10.1016\/j.ygyno.2018.08.002","journal-title":"Gynecol Oncol"},{"key":"1712_CR34","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.ygyno.2020.05.021","volume":"158","author":"A Gadducci","year":"2020","unstructured":"Gadducci A, Aletti GD (2020) Locally advanced squamous cell carcinoma of the vulva: A challenging question for gynecologic oncologists. Gynecol Oncol 158:208\u2013217","journal-title":"Gynecol Oncol"},{"key":"1712_CR35","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.ejim.2018.02.012","volume":"53","author":"L Tagliaferri","year":"2018","unstructured":"Tagliaferri L, Gobitti C, Colloca GF et al (2018) A new standardized data collection system for interdisciplinary thyroid cancer management: thyroid COBRA. Eur J Intern Med 53:73\u201378. https:\/\/doi.org\/10.1016\/j.ejim.2018.02.012","journal-title":"Eur J Intern Med"},{"key":"1712_CR36","doi-asserted-by":"publisher","first-page":"105","DOI":"10.5114\/jcb.2020.94579","volume":"12","author":"V Lancellotta","year":"2020","unstructured":"Lancellotta V, Guinot JL, Fionda B et al (2020) SKIN-COBRA (Consortium for Brachytherapy data Analysis) ontology: the first step towards interdisciplinary standardized data collection for personalized oncology in skin cancer. J Contemp Brachytherapy 12:105\u2013110. https:\/\/doi.org\/10.5114\/jcb.2020.94579","journal-title":"J Contemp Brachytherapy"},{"key":"1712_CR37","doi-asserted-by":"publisher","first-page":"2891","DOI":"10.26355\/eurrev_202204_28620","volume":"26","author":"R Iezzi","year":"2022","unstructured":"Iezzi R, Cas\u00e0 C, Posa A et al (2022) Project for interventional Oncology LArge-database in liveR Hepatocellular carcinoma \u2013 Preliminary CT-based radiomic analysis (POLAR Liver 1.1). Eur Rev Med Pharmacol Sci 26:2891\u20132899. https:\/\/doi.org\/10.26355\/eurrev_202204_28620","journal-title":"Eur Rev Med Pharmacol Sci"}],"container-title":["La radiologia medica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11547-023-01712-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11547-023-01712-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11547-023-01712-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T09:56:40Z","timestamp":1706090200000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11547-023-01712-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,12]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["1712"],"URL":"https:\/\/doi.org\/10.1007\/s11547-023-01712-8","relation":{},"ISSN":["1826-6983"],"issn-type":[{"value":"1826-6983","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,12]]},"assertion":[{"value":"20 June 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 August 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was waived by the local Ethics Committee of Fondazione Policlinico Universitario \"A. Gemelli\" IRCCS in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent informed"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}}]}}