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@ARTICLE{Meixner:177263,
      author       = {E. Meixner and N. Arians and N. Bougatf and L. Hoeltgen and
                      L. König and K. Lang and C. Domschke and M. Wallwiener and
                      J. W. Lischalk and F. K. F. Kommoss and J. Debus$^*$ and J.
                      Hörner-Rieber},
      title        = {{V}aginal cancer treated with curative radiotherapy with or
                      without concomitant chemotherapy: oncologic outcomes and
                      prognostic factors.},
      journal      = {Tumori journal},
      volume       = {109},
      number       = {1},
      issn         = {2038-2529},
      address      = {Thousand Oaks, Calif.},
      publisher    = {Sage Publishing},
      reportid     = {DKFZ-2021-02396},
      pages        = {112-120},
      year         = {2023},
      note         = {2023 Feb;109(1):112-120},
      abstract     = {Vaginal cancer is a rare disease for which prospective
                      randomized trials do not exist. We aimed to assess survival
                      outcomes, patterns of recurrence, prognostic factors, and
                      toxicity in the curative treatment using image-guided
                      radiotherapy (RT).In this retrospective review, we
                      identified 53 patients who were treated at a single center
                      with external beam radiotherapy and brachytherapy with or
                      without concomitant chemotherapy from 2000 to 2021.With a
                      median follow-up of 64.5 months, the Kaplan-Meier 2-, 5-,
                      and 7-year overall survival (OS) was found to be $74.8\%,$
                      $62.8\%,$ and $58.9\%,$ respectively. Local and distant
                      control were $67.8\%,$ $65.0\%,$ and $65.0\%$ and $74.4\%,$
                      $62.6\%,$ and $62.6\%$ at 2, 5, and 7 years, respectively.
                      In univariate Cox proportional hazards ratio analysis, OS
                      was significantly correlated to FIGO stage (hazard ratio
                      [HR] 1.78, p = 0.042), postoperative RT (HR 0.41, p =
                      0.044), and concomitant chemotherapy (HR 0.31, p = 0.009).
                      Local control rates were superior when an equivalent dose in
                      2-Gy fractions (EQD2) of ⩾65 Gy was delivered (HR 0.216, p
                      = 0.028) and with the use of concurrent chemotherapy (HR
                      0.248, p = 0.011). Not surprisingly, local control was
                      inferior for patients with a higher TNM stage (HR 3.303, p =
                      0.027). Minimal toxicity was observed with no patients
                      having documentation of high-grade toxicity (CTCAE grade
                      3+).In treatment of vaginal cancer, high-dose RT in
                      combination with brachytherapy is well tolerated and results
                      in effective local control rates, which significantly
                      improve with an EQD2(α/β=10) ⩾65 Gy. Multivariate
                      analyses revealed concomitant chemotherapy was a positive
                      prognostic factor for overall and progression-free
                      survival.},
      keywords     = {EQD2 (Other) / Squamous cell carcinoma of the vagina
                      (Other) / carbon ions (Other) / high-dose-rate brachytherapy
                      (Other) / vaginal neoplasms (Other)},
      cin          = {E050},
      ddc          = {610},
      cid          = {I:(DE-He78)E050-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34724840},
      doi          = {10.1177/03008916211056369},
      url          = {https://inrepo02.dkfz.de/record/177263},
}