{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T07:06:54Z","timestamp":1763536014865,"version":"3.40.5"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,13]],"date-time":"2022-11-13T00:00:00Z","timestamp":1668297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the clinical outcomes and toxicity in patients with locally advanced cervical cancer treated with supplementary applicator guided\u2010intensity modulated radiation therapy (IMRT) based on conventional intracavitary brachytherapy (IC\/IMRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Centre, China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Large high\u2010risk clinical target volume (HR\u2010CTV) volume (&gt;40\u2009ml) at the time of brachytherapy cervical cancer patients were recruited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study is a retrospective analysis of 76 patients with locally advanced cervical cancer (FIGO IIB\u2010IVA) treated with concurrent chemoradiotherapy followed by IC\/IMRT between June 2010 and October 2016. External radiotherapy (45\u2009Gy in 25 fractions) was adminstered with cisplatin chemotherapy treatment before IC\/IMRT. The IMRT plan was optimised using the ICBT plan base dose plan by an inverse dose optimisation tool which allows the use of DVH constraints on the total dose of ICBT. A seven\u2010field gantry angle IMRT plan was devised to avoid hotspots when optimising the boost plan. The prescription dose for HR\u2010CTV and IR\u2010CTV were 6\u00a0and 5\u00a0Gy per fraction for five fractions, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean HR\u2010CTV was 65.8\u2009\u00b1\u200923.6\u00a0ml at the time of brachytherapy. D90 for HR\u2010CTV and IR\u2010CTV were 88.7\u2009\u00b1\u20093.6\u00a0Gy and 78.1\u2009\u00b1\u20092.5\u00a0Gy. D2cc for bladder, rectum, sigmoid and small intestine were 71.8\u2009\u00b1\u20093.8, 64.6\u2009\u00b1\u20094.9, 63.9\u2009\u00b1\u20095.3\u00a0and 56.7\u2009\u00b1\u20098.7\u00a0Gy, respectively. Median follow\u2010up was 85\u2009months (47.9\u2013124.2\u00a0months). Five\u2010year local recurrence\u2010free survival rate, metastasis recurrence\u2010free survival rate, disease\u2010free survival rate and cancer\u2010special survival rate were 87.6, 82.4, 70.9 and 76.3%, respectively. The grade 1\u2009+\u20092 gastrointestinal and urinary late toxicities were 15.8 and 21.1%, and grade 3 late toxicities were 3.9 and 5.2%, respectively. Neither acute nor late grade 4 gastrointestinal or urinary toxicities were seen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combination of ICBT with an applicator\u2010guided supplementary IMRT boost achieved excellent local control and overall survival with low toxicity for bulky residual cervical tumour.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17340","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T09:58:08Z","timestamp":1667555888000},"page":"231-237","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical outcomes of conventional <scp>HDR<\/scp> intracavitary brachytherapy combined with complementary applicator\u2010guided intensity modulated radiotherapy boost in patients with bulky cervical tumour"],"prefix":"10.1111","volume":"130","author":[{"given":"Shun","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Sichuan Cancer Hospital &amp; 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