Increased genitourinary fistula rate after bevacizumab in recurrent cervical cancer patients initially treated with definitive radiochemotherapy and image-guided adaptive brachytherapy
Background and purpose Patients with recurrent cervical cancer (RecCC) who received definitive radiochemotherapy including image-guided adaptive brachytherapy (IGABT) as primary treatment are currently treated in our institution with palliative intent by chemotherapy (CHT) combined with bevacizumab...
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| Veröffentlicht in: | Strahlentherapie und Onkologie 2017-12, Vol.193 (12), p.1056-1065 |
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| container_title | Strahlentherapie und Onkologie |
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| creator | Sturdza, Alina Hofmann, Sandra Kranawetter, Marlene Polterauer, Stephan Grimm, Christoph Krainer, Michael Kirisits, Christian Pötter, Richard Reinthaller, Alexander Schwameis, Richard |
| description | Background and purpose
Patients with recurrent cervical cancer (RecCC) who received definitive radiochemotherapy including image-guided adaptive brachytherapy (IGABT) as primary treatment are currently treated in our institution with palliative intent by chemotherapy (CHT) combined with bevacizumab (BEV). We aim to evaluate the risk of gastrointestinal (GI)/genitourinary (GU) fistula formation in these patients.
Materials and methods
Data of 35 consecutive patients with RecCC treated initially with radiochemotherapy and IGABT were collected. Known and presumed risk factors associated with fistula formation were evaluated. Fistula rate was compared between patients receiving CHT or CHT+BEV.
Results
Of the 35 patients, 25 received CHT and 10 patients received CHT+BEV. Clinical characteristics were comparable. Fistulae were reported in 6 patients: two fistulae (8%) in the CHT group, four (40%) in the CHT+BEV group. GU fistula occurred in the CHT+BEV group only (3/4). Of these 6 patients with fistulae, 5 (83%) had undergone previous invasive procedures after the diagnosis of RecCC and 1 patient had undergone pelvic re-irradiation; 3/6 patients had developed a local recurrence. No other risk factors for fistula formation were identified.
Conclusion
In patients with RecCC after definitive radiochemotherapy including IGABT, the addition of BEV to CHT may increase the risk for GU fistula formation, particularly after invasive pelvic procedures. Future clinical studies are required to identify predictors for fistula formation to subsequently improve patient selection for the addition of BEV in the RecCC setting. |
| doi_str_mv | 10.1007/s00066-017-1178-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5696499</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1966346973</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-a501c20c61e77c667b0f2f1bbbc2532daf533020e731defe052413e6e1623c153</originalsourceid><addsrcrecordid>eNp1UU1v1DAUjBCILoUfwAVZ4hzwR2JvLkio4qNSJS4gcbNenJfEVdZZbGdp-GX8PF67S1UOnGx55s2M3xTFS8HfCM7N28Q517rkwpRCmG1586jYiEo1JW-a74-LDQFNaUS9PSuepXTNudBVUz0tzuTWSFELvil-XwYXERJ2bMDg87xEHyCurPcpLxOwCBkZ9Bkja_EAzv9adtAyH1hEt8SIITOH8eAdTMxBoDvbQ_b0nojls4dpWlkmk0wmP30eWYf9HXJAku_87EbczXnECPuVQeiY38GA5bD4jkagg_0dt43gxvXEe1486WFK-OJ0nhffPn74evG5vPry6fLi_VXpKsNzCTUXTnKnBRrjtDYt72Uv2rZ1slayg75WikuORgmKhbyWlVCoUWipnKjVefHuqLtf2h12jv4VYbL7SBnjamfw9l8k-NEO88HWuqFtNyTw-iQQ5x8LpmyvacmBMlvRaK0q3RhFLHFkuTinFLG_dxDc3pZtj2Vb6tTelm1vaObVw2j3E3_bJYI8EhJBYcD4wPq_qn8ALvq9Eg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1966346973</pqid></control><display><type>article</type><title>Increased genitourinary fistula rate after bevacizumab in recurrent cervical cancer patients initially treated with definitive radiochemotherapy and image-guided adaptive brachytherapy</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Sturdza, Alina ; Hofmann, Sandra ; Kranawetter, Marlene ; Polterauer, Stephan ; Grimm, Christoph ; Krainer, Michael ; Kirisits, Christian ; Pötter, Richard ; Reinthaller, Alexander ; Schwameis, Richard</creator><creatorcontrib>Sturdza, Alina ; Hofmann, Sandra ; Kranawetter, Marlene ; Polterauer, Stephan ; Grimm, Christoph ; Krainer, Michael ; Kirisits, Christian ; Pötter, Richard ; Reinthaller, Alexander ; Schwameis, Richard</creatorcontrib><description>Background and purpose
Patients with recurrent cervical cancer (RecCC) who received definitive radiochemotherapy including image-guided adaptive brachytherapy (IGABT) as primary treatment are currently treated in our institution with palliative intent by chemotherapy (CHT) combined with bevacizumab (BEV). We aim to evaluate the risk of gastrointestinal (GI)/genitourinary (GU) fistula formation in these patients.
Materials and methods
Data of 35 consecutive patients with RecCC treated initially with radiochemotherapy and IGABT were collected. Known and presumed risk factors associated with fistula formation were evaluated. Fistula rate was compared between patients receiving CHT or CHT+BEV.
Results
Of the 35 patients, 25 received CHT and 10 patients received CHT+BEV. Clinical characteristics were comparable. Fistulae were reported in 6 patients: two fistulae (8%) in the CHT group, four (40%) in the CHT+BEV group. GU fistula occurred in the CHT+BEV group only (3/4). Of these 6 patients with fistulae, 5 (83%) had undergone previous invasive procedures after the diagnosis of RecCC and 1 patient had undergone pelvic re-irradiation; 3/6 patients had developed a local recurrence. No other risk factors for fistula formation were identified.
Conclusion
In patients with RecCC after definitive radiochemotherapy including IGABT, the addition of BEV to CHT may increase the risk for GU fistula formation, particularly after invasive pelvic procedures. Future clinical studies are required to identify predictors for fistula formation to subsequently improve patient selection for the addition of BEV in the RecCC setting.</description><identifier>ISSN: 0179-7158</identifier><identifier>EISSN: 1439-099X</identifier><identifier>DOI: 10.1007/s00066-017-1178-x</identifier><identifier>PMID: 28721510</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Antineoplastic Agents, Immunological - therapeutic use ; Austria - epidemiology ; Bevacizumab - therapeutic use ; Brachytherapy - utilization ; Cancer ; Cervical cancer ; Chemoradiotherapy - utilization ; Chemotherapy ; Combined Modality Therapy - utilization ; Digestive System Fistula - epidemiology ; Female ; Humans ; Immunotherapy ; Incidence ; Medicine ; Medicine & Public Health ; Middle Aged ; Monoclonal antibodies ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - therapy ; Oncology ; Original ; Original Article ; Patients ; Radiation therapy ; Radiotherapy ; Radiotherapy, Image-Guided - utilization ; Retrospective Studies ; Risk analysis ; Risk Factors ; Targeted cancer therapy ; Urinary Fistula - epidemiology ; Uterine Cervical Neoplasms - epidemiology ; Uterine Cervical Neoplasms - therapy</subject><ispartof>Strahlentherapie und Onkologie, 2017-12, Vol.193 (12), p.1056-1065</ispartof><rights>The Author(s) 2017</rights><rights>Strahlentherapie und Onkologie is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-a501c20c61e77c667b0f2f1bbbc2532daf533020e731defe052413e6e1623c153</citedby><cites>FETCH-LOGICAL-c470t-a501c20c61e77c667b0f2f1bbbc2532daf533020e731defe052413e6e1623c153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00066-017-1178-x$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00066-017-1178-x$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28721510$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sturdza, Alina</creatorcontrib><creatorcontrib>Hofmann, Sandra</creatorcontrib><creatorcontrib>Kranawetter, Marlene</creatorcontrib><creatorcontrib>Polterauer, Stephan</creatorcontrib><creatorcontrib>Grimm, Christoph</creatorcontrib><creatorcontrib>Krainer, Michael</creatorcontrib><creatorcontrib>Kirisits, Christian</creatorcontrib><creatorcontrib>Pötter, Richard</creatorcontrib><creatorcontrib>Reinthaller, Alexander</creatorcontrib><creatorcontrib>Schwameis, Richard</creatorcontrib><title>Increased genitourinary fistula rate after bevacizumab in recurrent cervical cancer patients initially treated with definitive radiochemotherapy and image-guided adaptive brachytherapy</title><title>Strahlentherapie und Onkologie</title><addtitle>Strahlenther Onkol</addtitle><addtitle>Strahlenther Onkol</addtitle><description>Background and purpose
Patients with recurrent cervical cancer (RecCC) who received definitive radiochemotherapy including image-guided adaptive brachytherapy (IGABT) as primary treatment are currently treated in our institution with palliative intent by chemotherapy (CHT) combined with bevacizumab (BEV). We aim to evaluate the risk of gastrointestinal (GI)/genitourinary (GU) fistula formation in these patients.
Materials and methods
Data of 35 consecutive patients with RecCC treated initially with radiochemotherapy and IGABT were collected. Known and presumed risk factors associated with fistula formation were evaluated. Fistula rate was compared between patients receiving CHT or CHT+BEV.
Results
Of the 35 patients, 25 received CHT and 10 patients received CHT+BEV. Clinical characteristics were comparable. Fistulae were reported in 6 patients: two fistulae (8%) in the CHT group, four (40%) in the CHT+BEV group. GU fistula occurred in the CHT+BEV group only (3/4). Of these 6 patients with fistulae, 5 (83%) had undergone previous invasive procedures after the diagnosis of RecCC and 1 patient had undergone pelvic re-irradiation; 3/6 patients had developed a local recurrence. No other risk factors for fistula formation were identified.
Conclusion
In patients with RecCC after definitive radiochemotherapy including IGABT, the addition of BEV to CHT may increase the risk for GU fistula formation, particularly after invasive pelvic procedures. Future clinical studies are required to identify predictors for fistula formation to subsequently improve patient selection for the addition of BEV in the RecCC setting.</description><subject>Aged</subject><subject>Antineoplastic Agents, Immunological - therapeutic use</subject><subject>Austria - epidemiology</subject><subject>Bevacizumab - therapeutic use</subject><subject>Brachytherapy - utilization</subject><subject>Cancer</subject><subject>Cervical cancer</subject><subject>Chemoradiotherapy - utilization</subject><subject>Chemotherapy</subject><subject>Combined Modality Therapy - utilization</subject><subject>Digestive System Fistula - epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Incidence</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - therapy</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Radiotherapy, Image-Guided - utilization</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Targeted cancer therapy</subject><subject>Urinary Fistula - epidemiology</subject><subject>Uterine Cervical Neoplasms - epidemiology</subject><subject>Uterine Cervical Neoplasms - therapy</subject><issn>0179-7158</issn><issn>1439-099X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1UU1v1DAUjBCILoUfwAVZ4hzwR2JvLkio4qNSJS4gcbNenJfEVdZZbGdp-GX8PF67S1UOnGx55s2M3xTFS8HfCM7N28Q517rkwpRCmG1586jYiEo1JW-a74-LDQFNaUS9PSuepXTNudBVUz0tzuTWSFELvil-XwYXERJ2bMDg87xEHyCurPcpLxOwCBkZ9Bkja_EAzv9adtAyH1hEt8SIITOH8eAdTMxBoDvbQ_b0nojls4dpWlkmk0wmP30eWYf9HXJAku_87EbczXnECPuVQeiY38GA5bD4jkagg_0dt43gxvXEe1486WFK-OJ0nhffPn74evG5vPry6fLi_VXpKsNzCTUXTnKnBRrjtDYt72Uv2rZ1slayg75WikuORgmKhbyWlVCoUWipnKjVefHuqLtf2h12jv4VYbL7SBnjamfw9l8k-NEO88HWuqFtNyTw-iQQ5x8LpmyvacmBMlvRaK0q3RhFLHFkuTinFLG_dxDc3pZtj2Vb6tTelm1vaObVw2j3E3_bJYI8EhJBYcD4wPq_qn8ALvq9Eg</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Sturdza, Alina</creator><creator>Hofmann, Sandra</creator><creator>Kranawetter, Marlene</creator><creator>Polterauer, Stephan</creator><creator>Grimm, Christoph</creator><creator>Krainer, Michael</creator><creator>Kirisits, Christian</creator><creator>Pötter, Richard</creator><creator>Reinthaller, Alexander</creator><creator>Schwameis, Richard</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20171201</creationdate><title>Increased genitourinary fistula rate after bevacizumab in recurrent cervical cancer patients initially treated with definitive radiochemotherapy and image-guided adaptive brachytherapy</title><author>Sturdza, Alina ; Hofmann, Sandra ; Kranawetter, Marlene ; Polterauer, Stephan ; Grimm, Christoph ; Krainer, Michael ; Kirisits, Christian ; Pötter, Richard ; Reinthaller, Alexander ; Schwameis, Richard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-a501c20c61e77c667b0f2f1bbbc2532daf533020e731defe052413e6e1623c153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Antineoplastic Agents, Immunological - therapeutic use</topic><topic>Austria - epidemiology</topic><topic>Bevacizumab - therapeutic use</topic><topic>Brachytherapy - utilization</topic><topic>Cancer</topic><topic>Cervical cancer</topic><topic>Chemoradiotherapy - utilization</topic><topic>Chemotherapy</topic><topic>Combined Modality Therapy - utilization</topic><topic>Digestive System Fistula - epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Immunotherapy</topic><topic>Incidence</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Monoclonal antibodies</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - therapy</topic><topic>Oncology</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Radiotherapy, Image-Guided - utilization</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Targeted cancer therapy</topic><topic>Urinary Fistula - epidemiology</topic><topic>Uterine Cervical Neoplasms - epidemiology</topic><topic>Uterine Cervical Neoplasms - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sturdza, Alina</creatorcontrib><creatorcontrib>Hofmann, Sandra</creatorcontrib><creatorcontrib>Kranawetter, Marlene</creatorcontrib><creatorcontrib>Polterauer, Stephan</creatorcontrib><creatorcontrib>Grimm, Christoph</creatorcontrib><creatorcontrib>Krainer, Michael</creatorcontrib><creatorcontrib>Kirisits, Christian</creatorcontrib><creatorcontrib>Pötter, Richard</creatorcontrib><creatorcontrib>Reinthaller, Alexander</creatorcontrib><creatorcontrib>Schwameis, Richard</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Strahlentherapie und Onkologie</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sturdza, Alina</au><au>Hofmann, Sandra</au><au>Kranawetter, Marlene</au><au>Polterauer, Stephan</au><au>Grimm, Christoph</au><au>Krainer, Michael</au><au>Kirisits, Christian</au><au>Pötter, Richard</au><au>Reinthaller, Alexander</au><au>Schwameis, Richard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased genitourinary fistula rate after bevacizumab in recurrent cervical cancer patients initially treated with definitive radiochemotherapy and image-guided adaptive brachytherapy</atitle><jtitle>Strahlentherapie und Onkologie</jtitle><stitle>Strahlenther Onkol</stitle><addtitle>Strahlenther Onkol</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>193</volume><issue>12</issue><spage>1056</spage><epage>1065</epage><pages>1056-1065</pages><issn>0179-7158</issn><eissn>1439-099X</eissn><abstract>Background and purpose
Patients with recurrent cervical cancer (RecCC) who received definitive radiochemotherapy including image-guided adaptive brachytherapy (IGABT) as primary treatment are currently treated in our institution with palliative intent by chemotherapy (CHT) combined with bevacizumab (BEV). We aim to evaluate the risk of gastrointestinal (GI)/genitourinary (GU) fistula formation in these patients.
Materials and methods
Data of 35 consecutive patients with RecCC treated initially with radiochemotherapy and IGABT were collected. Known and presumed risk factors associated with fistula formation were evaluated. Fistula rate was compared between patients receiving CHT or CHT+BEV.
Results
Of the 35 patients, 25 received CHT and 10 patients received CHT+BEV. Clinical characteristics were comparable. Fistulae were reported in 6 patients: two fistulae (8%) in the CHT group, four (40%) in the CHT+BEV group. GU fistula occurred in the CHT+BEV group only (3/4). Of these 6 patients with fistulae, 5 (83%) had undergone previous invasive procedures after the diagnosis of RecCC and 1 patient had undergone pelvic re-irradiation; 3/6 patients had developed a local recurrence. No other risk factors for fistula formation were identified.
Conclusion
In patients with RecCC after definitive radiochemotherapy including IGABT, the addition of BEV to CHT may increase the risk for GU fistula formation, particularly after invasive pelvic procedures. Future clinical studies are required to identify predictors for fistula formation to subsequently improve patient selection for the addition of BEV in the RecCC setting.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28721510</pmid><doi>10.1007/s00066-017-1178-x</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Antineoplastic Agents, Immunological - therapeutic use Austria - epidemiology Bevacizumab - therapeutic use Brachytherapy - utilization Cancer Cervical cancer Chemoradiotherapy - utilization Chemotherapy Combined Modality Therapy - utilization Digestive System Fistula - epidemiology Female Humans Immunotherapy Incidence Medicine Medicine & Public Health Middle Aged Monoclonal antibodies Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - therapy Oncology Original Original Article Patients Radiation therapy Radiotherapy Radiotherapy, Image-Guided - utilization Retrospective Studies Risk analysis Risk Factors Targeted cancer therapy Urinary Fistula - epidemiology Uterine Cervical Neoplasms - epidemiology Uterine Cervical Neoplasms - therapy |
| title | Increased genitourinary fistula rate after bevacizumab in recurrent cervical cancer patients initially treated with definitive radiochemotherapy and image-guided adaptive brachytherapy |
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