Impact of reduced margin pelvic radiotherapy on gastrointestinal toxicity and outcome in gynecological cancer

Cibula, 2023, ESGO/ESTRO/ESP Guidelines for the management of patients with cervical cancer - Update 2023, Int J Gynecol Cancer, 33, 649, 10.1136/ijgc-2023-004429 Concin, 2021, ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma, Radiother Oncol, 154, 327, 10.1016/j.radonc.2020.11.018 Viswanathan, 2014, Complications of pelvic radiation in patients treated for gynecologic malignancies, Cancer, 120, 3870, 10.1002/cncr.28849 Bartsch, 2021, The role of dietary supplements, including biotics, glutamine, polyunsaturated fatty acids and polyphenols, in reducing gastrointestinal side effects in patients undergoing pelvic radiotherapy: A systematic review and meta-analysis, Clin Transl Radiat Oncol, 29, 11 Klopp, 2018, Patient-Reported Toxicity During Pelvic Intensity-Modulated Radiation Therapy: NRG Oncology-RTOG 1203, J Clin Oncol, 36, 2538, 10.1200/JCO.2017.77.4273 Chopra, 2021, Late Toxicity After Adjuvant Conventional Radiation Versus Image-Guided Intensity-Modulated Radiotherapy for Cervical Cancer (PARCER): A Randomized Controlled Trial, J Clin Oncol, 39, 3682, 10.1200/JCO.20.02530 Yeung, 2022, Intensity-Modulated Radiation Therapy Reduces Patient-Reported Chronic Toxicity Compared With Conventional Pelvic Radiation Therapy: Updated Results of a Phase III Trial, J Clin Oncol, 40, 3115, 10.1200/JCO.21.02831 Chen, 2015, Toxicity and cost-effectiveness analysis of intensity modulated radiation therapy versus 3-dimensional conformal radiation therapy for postoperative treatment of gynecologic cancers, Gynecol Oncol, 136, 521, 10.1016/j.ygyno.2014.12.039 Wortman, 2022, Radiation Therapy Techniques and Treatment-Related Toxicity in the PORTEC-3 Trial: Comparison of 3-Dimensional Conformal Radiation Therapy Versus Intensity-Modulated Radiation Therapy, Int J Radiat Oncol Biol Phys, 112, 390, 10.1016/j.ijrobp.2021.09.042 Small, 2008, Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy in postoperative treatment of endometrial and cervical cancer, Int J Radiat Oncol Biol Phys, 71, 428, 10.1016/j.ijrobp.2007.09.042 Small, 2021, NRG Oncology/RTOG Consensus Guidelines for Delineation of Clinical Target Volume for Intensity Modulated Pelvic Radiation Therapy in Postoperative Treatment of Endometrial and Cervical Cancer: An Update, Int J Radiat Oncol Biol Phys, 109, 413, 10.1016/j.ijrobp.2020.08.061 Taylor, 2005, Mapping pelvic lymph nodes: guidelines for delineation in intensity-modulated radiotherapy, Int J Radiat Oncol Biol Phys, 63, 1604, 10.1016/j.ijrobp.2005.05.062 Schaefer, 2016, Quantitative Histomorphometry of the Healthy Peritoneum, Sci Rep, 6, 10.1038/srep21344 Lee, 2021, Progressive Skeletal Muscle Loss After Surgery and Adjuvant Radiotherapy Impact Survival Outcomes in Patients With Early Stage Cervical Cancer, Front Nutr, 8 Lee, 2021, Association of Patient-Reported Outcomes and Nutrition with Body Composition in Women with Gynecologic Cancer Undergoing Post-Operative Pelvic Radiotherapy: An Observational Study, Nutrients, 13, 2629, 10.3390/nu13082629 Lee, 2022, Optimal prophylactic para-aortic radiotherapy in locally advanced cervical cancer: anatomy-based versus margin-based delineation, Int J Gynecol Cancer, 32, 606, 10.1136/ijgc-2021-003298 Yeung, 2020, Improvement in Patient-Reported Outcomes With Intensity-Modulated Radiotherapy (RT) Compared With Standard RT: A Report From the NRG Oncology RTOG 1203 Study, J Clin Oncol, 38, 1685, 10.1200/JCO.19.02381 Kirchheiner, 2012, Strahlenther Onkol, 188, 933, 10.1007/s00066-012-0156-6 Lee, 2021, Association of bowel radiation dose-volume with skeletal muscle loss during pelvic intensity-modulated radiotherapy in cervical cancer, Support Care Cancer, 29, 5497, 10.1007/s00520-021-06131-x Pötter, 2018, The EMBRACE II study: The outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies, Clin Transl Radiat Oncol, 9, 48 Shelley, 2023, Implementing cone-beam computed tomography-guided online adaptive radiotherapy in cervical cancer, Clin Transl Radiat Oncol, 40, 100596 Gort, 2021, Inter-fraction motion robustness and organ sparing potential of proton therapy for cervical cancer, Radiother Oncol, 154, 194, 10.1016/j.radonc.2020.09.022