{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:21:08Z","timestamp":1789399268865,"version":"build-2803163510"},"reference-count":51,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","redjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Radiation Oncology*Biology*Physics"],"published-print":{"date-parts":[[2022,3]]},"DOI":"10.1016\/j.ijrobp.2021.09.055","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T19:53:52Z","timestamp":1634846032000},"page":"681-693","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":34,"title":["Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future"],"prefix":"10.1016","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1953-7313","authenticated-orcid":false,"given":"Sofia","family":"Spampinato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina B.K.","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"P\u00f6tter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars U.","family":"Fokdal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus","family":"Chargari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob C.","family":"Lindegaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian P.","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Sturdza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina M.","family":"J\u00fcrgenliemk-Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umesh","family":"Mahantshetty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hoskin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Segedin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavana","family":"Rai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjersti","family":"Bruheim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ericka","family":"Wiebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elzbieta","family":"Van der Steen-Banasik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Van Limbergen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marit","family":"Sundset","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley R.","family":"Pieters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludy C.H.W.","family":"Lutgens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li Tee","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Villafranca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Smet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noha","family":"Jastaniyah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remi A.","family":"Nout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Kirisits","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supriya","family":"Chopra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Kirchheiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Tanderup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"EMBRACE Collaborative Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijrobp.2021.09.055_bib0001","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.radonc.2018.03.003","article-title":"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","volume":"127","author":"Cibula","year":"2018","journal-title":"Radiother Oncol"},{"issue":"3","key":"10.1016\/j.ijrobp.2021.09.055_bib0002","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.radonc.2016.03.011","article-title":"Image guided brachytherapy in locally advanced cervical cancer: Improved pelvic control and survival in RetroEMBRACE, a multicenter cohort study","volume":"120","author":"Sturdza","year":"2016","journal-title":"Radiotherapy and Oncology"},{"issue":"3","key":"10.1016\/j.ijrobp.2021.09.055_bib0003","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.radonc.2016.05.014","article-title":"Effect of tumor dose, volume and overall treatment time on local control after radiochemotherapy including MRI guided brachytherapy of locally advanced cervical cancer","volume":"120","author":"Tanderup","year":"2016","journal-title":"Radiother Oncol"},{"issue":"2","key":"10.1016\/j.ijrobp.2021.09.055_bib0004","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.radonc.2007.04.012","article-title":"Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer","volume":"83","author":"P\u00f6tter","year":"2007","journal-title":"Radiotherapy and Oncology"},{"issue":"7","key":"10.1016\/j.ijrobp.2021.09.055_bib0005","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.3109\/0284186X.2013.818253","article-title":"MRI-guided adaptive radiotherapy in locally advanced cervical cancer from a Nordic perspective","volume":"52","author":"Lindegaard","year":"2013","journal-title":"Acta Oncologica"},{"issue":"3","key":"10.1016\/j.ijrobp.2021.09.055_bib0006","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.radonc.2016.06.006","article-title":"Dose\u2013volume effect relationships for late rectal morbidity in patients treated with chemoradiation and MRI-guided adaptive brachytherapy for locally advanced cervical cancer: Results from the prospective multicenter EMBRACE study","volume":"120","author":"Mazeron","year":"2016","journal-title":"Radiotherapy and Oncology"},{"issue":"3","key":"10.1016\/j.ijrobp.2021.09.055_bib0007","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.radonc.2018.05.002","article-title":"Physician assessed and patient reported urinary morbidity after radio-chemotherapy and image guided adaptive brachytherapy for locally advanced cervical cancer","volume":"127","author":"Fokdal","year":"2018","journal-title":"Radiother Oncol"},{"issue":"3","key":"10.1016\/j.ijrobp.2021.09.055_bib0008","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.radonc.2018.05.016","article-title":"Bowel morbidity following radiochemotherapy and image-guided adaptive brachytherapy for cervical cancer: Physician- and patient reported outcome from the EMBRACE study","volume":"127","author":"Jensen","year":"2018","journal-title":"Radiotherapy and Oncology"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0009","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.radonc.2012.04.007","article-title":"Impact of 3D image-based PDR brachytherapy on outcome of patients treated for cervix carcinoma in France: Results of the French STIC prospective study","volume":"103","author":"Charra-Brunaud","year":"2012","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0171461","article-title":"Identifying radiation-induced survivorship syndromes affecting bowel health in a cohort of gynecological cancer survivors","volume":"12","author":"Steineck","year":"2017","journal-title":"PLoS ONE"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0011","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1016\/S1470-2045(07)70341-8","article-title":"Gastrointestinal symptoms after pelvic radiotherapy: A new understanding to improve management of symptomatic patients","volume":"8","author":"Andreyev","year":"2007","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0012","doi-asserted-by":"crossref","first-page":"2046","DOI":"10.1016\/S0140-6736(13)61946-7","article-title":"Radiation induced bowel injury: A neglected problem","volume":"382","author":"Denham","year":"2013","journal-title":"Lancet"},{"issue":"4","key":"10.1016\/j.ijrobp.2021.09.055_bib0013","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/S1470-2045(20)30753-1","article-title":"MRI-guided adaptive brachytherapy in locally advanced cervical cancer (EMBRACE-I): a multicentre prospective cohort study","volume":"22","author":"P\u00f6tter","year":"2021","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0014","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1136\/gut.2004.062596","article-title":"Gastrointestinal complications of pelvic radiotherapy: Are they of any importance?","volume":"54","author":"Andreyev","year":"2005","journal-title":"Gut"},{"issue":"1","key":"10.1016\/j.ijrobp.2021.09.055_bib0015","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.radonc.2015.12.025","article-title":"Dose-effect relationship and risk factors for vaginal stenosis after definitive radio(chemo)therapy with image-guided brachytherapy for locally advanced cervical cancer in the EMBRACE study","volume":"118","author":"Kirchheiner","year":"2016","journal-title":"Radiotherapy and Oncology"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0016","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1016\/j.ijrobp.2017.01.026","article-title":"Risk factors for pelvic insufficiency fractures in locally advanced cervical cancer following intensity modulated radiation therapy","volume":"97","author":"Ramlov","year":"2017","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"10.1016\/j.ijrobp.2021.09.055_bib0017","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.ijrobp.2018.11.006","article-title":"Risk Factors for Ureteral Stricture After Radiochemotherapy Including Image Guided Adaptive Brachytherapy in Cervical Cancer: Results From the EMBRACE Studies","volume":"103","author":"Fokdal","year":"2019","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0018","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.radonc.2020.10.003","article-title":"Importance of the ICRU bladder point dose on incidence and persistence of urinary frequency and incontinence in locally advanced cervical cancer: An EMBRACE analysis","volume":"158","author":"Spampinato","year":"2021","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0019","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.radonc.2021.01.019","article-title":"Risk factors and dose-effects for bladder fistula, bleeding and cystitis after radiotherapy with imaged-guided adaptive brachytherapy for cervical cancer: An EMBRACE analysis","volume":"158","author":"Spampinato","year":"2021","journal-title":"Radiother Oncol"},{"issue":"3","key":"10.1016\/j.ijrobp.2021.09.055_bib0020","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1016\/j.ijrobp.2020.10.006","article-title":"Dose-Volume Effects and Risk Factors for Late Diarrhea in Cervix Cancer Patients After Radiochemotherapy With Image Guided Adaptive Brachytherapy in the EMBRACE I Study","volume":"1109","author":"Jensen","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0021","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.radonc.2004.12.015","article-title":"Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (I): Concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV","volume":"74","author":"Haie-Meder","year":"2005","journal-title":"Radiother Oncol"},{"issue":"1","key":"10.1016\/j.ijrobp.2021.09.055_bib0022","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.radonc.2005.11.014","article-title":"Recommendations from gynaecological (GYN) GEC ESTRO working group (II): concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology","volume":"78","author":"P\u00f6tter","year":"2006","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0023","first-page":"105","article-title":"(Chapter 8: dose and volume parameters for prescribing, recording and reporting brachytherapy, alone and combined with external-beam radiotherapy)","volume":"13","year":"2016","journal-title":"J Int Comm Radiat Unit Measure"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0024","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/S1053-4296(03)00031-6","article-title":"CTCAE v3.0: Development of a comprehensive grading system for the adverse effects of cancer treatment","volume":"13","author":"Trotti","year":"2003","journal-title":"Semin Radiat Oncol"},{"issue":"2","key":"10.1016\/j.ijrobp.2021.09.055_bib0025","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.ijrobp.2019.10.027","article-title":"Late, Persistent, Substantial, Treatment-Related Symptoms After Radiation Therapy (LAPERS): A New Method for Longitudinal Analysis of Late Morbidity-Applied in the EMBRACE Study","volume":"106","author":"Kirchheiner","year":"2020","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0026","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ijgo.2009.02.009","article-title":"Revised FIGO staging for carcinoma of the cervix","volume":"105","author":"Pecorelli","year":"2009","journal-title":"Int J Gynecol Obstet"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0027","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.ijrobp.2019.08.040","article-title":"Reporting of late morbidity after radiation therapy in large prospective studies: A descriptive review of the current status","volume":"105","author":"Vittrup","year":"2019","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0028","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.ijrobp.2009.09.040","article-title":"Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): An introduction to the scientific issues","volume":"76","author":"Bentzen","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0029","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13014-019-1262-8","article-title":"A systematic review of dose-volume predictors and constraints for late bowel toxicity following pelvic radiotherapy","volume":"14","author":"Jadon","year":"2019","journal-title":"Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0030","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.ijrobp.2010.12.029","article-title":"Dose effect relationship for late side effects of the rectum and urinary bladder in magnetic resonance image-guided adaptive cervix cancer brachytherapy","volume":"82","author":"Georg","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0031","doi-asserted-by":"crossref","unstructured":"Aravindakshan D, Guram L, Hazare R, et\u00a0al., \u201cDosimetric Analysis of Sequential IMRT (SeB) Versus SIB for Lymph nodes in Cervical Cancer,\u201d ESTRO 2021 abstract book, 2021, 1618-1619.","DOI":"10.1016\/S0167-8140(21)08337-7"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0032","doi-asserted-by":"crossref","unstructured":"Berger T, Seppenwoolde Y, P\u00f6tter R, et\u00a0al., Importance of Technique, Target Selection, Contouring, Dose Prescription, and Dose-Planning in External Beam Radiation Therapy for Cervical Cancer: Evolution of Practice From EMBRACE-I to II. Int J Radiat Oncol Biol Phys. 2019 Jul 15;104(4):885-894.","DOI":"10.1016\/j.ijrobp.2019.03.020"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0033","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.ijrobp.2009.03.078","article-title":"Radiation dose-volume effects in radiation-induced rectal injury","volume":"76","author":"Michalski","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"10.1016\/j.ijrobp.2021.09.055_bib0034","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.semradonc.2020.05.008","article-title":"Evidence-Based Dose Planning Aims and Dose Prescription in Image-Guided Brachytherapy Combined With Radiochemotherapy in Locally Advanced Cervical Cancer","volume":"30","author":"Tanderup","year":"2020","journal-title":"Semin Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0035","doi-asserted-by":"crossref","DOI":"10.1053\/j.gastro.2020.04.014","article-title":"Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation global study","volume":"160","author":"Sperber","year":"2021","journal-title":"Gastroenterology"},{"issue":"3","key":"10.1016\/j.ijrobp.2021.09.055_bib0036","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.ijrobp.2013.11.214","article-title":"Predictors of grade 3 or higher late bowel toxicity in patients undergoing pelvic radiation for cervical cancer: results from a prospective study","volume":"188","author":"Chopra","year":"2014","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"11","key":"10.1016\/j.ijrobp.2021.09.055_bib0037","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1080\/0284186X.2016.1176247","article-title":"Defecation into clothing withoutforewarning and mean radiation dose to bowel and anal-sphincter among gynecological cancer survivors","volume":"55","author":"Lind","year":"2016","journal-title":"Acta Oncol"},{"issue":"1","key":"10.1016\/j.ijrobp.2021.09.055_bib0038","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ijrobp.2006.03.034","article-title":"Rectal bleeding, fecal incontinence, and high stool frequency after conformal radiotherapy for prostate cancer: normal tissue complication probability modeling","volume":"166","author":"Peeters","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"9","key":"10.1016\/j.ijrobp.2021.09.055_bib0039","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.3109\/0284186X.2015.1063779","article-title":"Relationships between dose to the gastro-intestinal tract and patient-reported symptom domains after radiotherapy for localized prostate cancer","volume":"54","author":"Thor","year":"2015","journal-title":"Acta Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0040","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.clon.2005.02.008","article-title":"Faecal incontinence: A late side-effect of pelvic radiotherapy","volume":"17","author":"Putta","year":"2005","journal-title":"Clin Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0041","doi-asserted-by":"crossref","unstructured":"S Chopra, T Dora, S Gupta, et\u00a0al., Phase III Randomized Trial of Postoperative Adjuvant Conventional Radiation (3DCRT) versus Image Guided Intensity Modulated Radiotherapy (IG-IMRT) in Cervical Cancer (PARCER): Final Analysis, Int J Radiat Oncol Biol Phys, 108 (3), 2020, S1\u2013S2.","DOI":"10.1016\/j.ijrobp.2020.07.2069"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0042","doi-asserted-by":"crossref","first-page":"185","DOI":"10.3748\/wjg.v19.i2.185","article-title":"Gastrointestinal radiation injury: Symptoms, risk factors and mechanisms","volume":"19","author":"Shadad","year":"2013","journal-title":"World J Gastroenterol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0043","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1080\/02841860500374513","article-title":"Can risk of radiotherapy-induced normal tissue complications be predicted from genetic profiles?","volume":"44","author":"Andreassen","year":"2005","journal-title":"Acta Oncologica"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0044","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1097\/IGC.0000000000000999","article-title":"The impact of cancer treatment on the gut and vaginal microbiome in women with a gynecological malignancy","volume":"27","author":"Muls","year":"2017","journal-title":"Int J Gynecol Cancer"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0045","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.radonc.2020.10.033","article-title":"The role of the gut microbiome on radiation therapy efficacy and gastrointestinal complications: A systematic review","volume":"156","author":"Tonneau","year":"2021","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0046","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13014-020-01735-9","article-title":"Radiotherapy and the gut microbiome: Facts and fiction","volume":"16","author":"Liu","year":"2021","journal-title":"Radiat Oncol"},{"issue":"6","key":"10.1016\/j.ijrobp.2021.09.055_bib0047","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.brachy.2020.08.011","article-title":"Initiatives for education, training, and dissemination of morbidity assessment and reporting in a multiinstitutional international context: Insights from the EMBRACE studies on cervical cancer","volume":"19","author":"Kirchheiner","year":"2020","journal-title":"Brachytherapy"},{"issue":"3","key":"10.1016\/j.ijrobp.2021.09.055_bib0048","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.radonc.2016.03.020","article-title":"Image guided adaptive brachytherapy with combined intracavitary and interstitial technique improves the therapeutic ratio in locally advanced cervical cancer: Analysis from the retroEMBRACE study","volume":"120","author":"Fokdal","year":"2016","journal-title":"Radiother Oncol"},{"issue":"5","key":"10.1016\/j.ijrobp.2021.09.055_bib0049","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1016\/j.ijrobp.2019.12.019","article-title":"Ring Versus Ovoids and Intracavitary Versus Intracavitary-Interstitial Applicators in Cervical Cancer Brachytherapy: Results From the EMBRACE I Study","volume":"1106","author":"Serban","year":"2020","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0050","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.radonc.2016.05.020","article-title":"Vaginal dose de-escalation in image guided adaptive brachytherapy for locally advanced cervical cancer","volume":"120","author":"Mohamed","year":"2016","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2021.09.055_bib0051","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.radonc.2017.01.015","article-title":"Clinical implementation of coverage probability planning for nodal boosting in locally advanced cervical cancer","volume":"123","author":"Ramlov","year":"2017","journal-title":"Radiother Oncol"}],"container-title":["International Journal of Radiation Oncology*Biology*Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301621029151?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301621029151?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T09:59:57Z","timestamp":1759744797000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0360301621029151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":51,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["S0360301621029151"],"URL":"https:\/\/doi.org\/10.1016\/j.ijrobp.2021.09.055","relation":{},"ISSN":["0360-3016"],"issn-type":[{"value":"0360-3016","type":"print"}],"subject":[],"published":{"date-parts":[[2022,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future","name":"articletitle","label":"Article Title"},{"value":"International Journal of Radiation Oncology*Biology*Physics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijrobp.2021.09.055","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}