title: Time course of late rectal- and urinary bladder side effects after MRI-guided adaptive brachytherapy for cervical cancer.
abstract: OBJECTIVE
  To analyze the time course of late rectal- and urinary bladder complications after brachytherapy for cervical cancer and to compare the incidence- and prevalence rates thereof.
  
  
  METHODS
  A total of 225 patients were treated with external-beam radiotherapy (EBRT) and magnetic resonance imaging (MRI)-guided brachytherapy with or without chemotherapy. Late side effects were assessed prospectively using the Late Effects in Normal Tissue--Subjective, Objective, Management and Analytic (LENT/SOMA) scale. The parameters analyzed were time to onset, duration, actuarial incidence- (occurrence of new side effects during a defined time period) and prevalence rates (side effects existing at a defined time point).
  
  
  RESULTS
  Median follow-up was 44 months. Side effects (grade 1-4) in rectum and bladder were present in 31 and 49 patients, 14 and 27 months (mean time to onset) after treatment, respectively. All rectal and 76 % of bladder side effects occurred within 3 years after radiotherapy. Mean duration of rectal events was 19 months; 81 % resolved within 3 years of their initial diagnosis. Mean duration of bladder side effects was 20 months; 61 % resolved within 3 years. The 3- and 5-year actuarial complication rates were 16 and 19 % in rectum and 18 and 28 % in bladder, respectively. The corresponding prevalence rates were 9 and 2 % (rectum) and 18 and 21 % (bladder), respectively.
  
  
  CONCLUSIONS
  Late side effects after cervical cancer radiotherapy are partially reversible, but their time course is organ-dependent. The combined presentation of incidence- and prevalence rates provides the most comprehensive information.
authors.affiliation: Department of Radiooncology, Medical University Vienna/AKH Wien, Währinger Gürtel 18-20, 1090, Vienna, Austria. petra.georg@akhwien.at
authors.forename: P
authors.initials: P
authors.lastname: Georg
authors.forename: A
authors.initials: A
authors.lastname: Boni
authors.forename: A
authors.initials: A
authors.lastname: Ghabuous
authors.forename: G
authors.initials: G
authors.lastname: Goldner
authors.forename: M P
authors.initials: MP
authors.lastname: Schmid
authors.forename: D
authors.initials: D
authors.lastname: Georg
authors.forename: R
authors.initials: R
authors.lastname: Pötter
authors.forename: W
authors.initials: W
authors.lastname: Dörr
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001918:Brachytherapy / Q000009:adverse effects*; D059248:Chemoradiotherapy / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053783:Magnetic Resonance Imaging, Interventional / Q000009:adverse effects*; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011832:Radiation Injuries / Q000453:epidemiology* / Q000209:etiology*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D061089:Radiotherapy, Image-Guided / Q000009:adverse effects*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012007:Rectum / Q000528:radiation effects*; D001743:Urinary Bladder / Q000528:radiation effects*; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin