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@ARTICLE{Meixner:181113,
      author       = {E. Meixner and L. Hoeltgen and P. Hoegen and L. König and
                      N. Arians and L. L. Michel and K. Smetanay and C. Fremd and
                      A. Schneeweiss and J. Debus$^*$ and J. Hörner-Rieber$^*$},
      title        = {{A}ge-{D}ependent {H}ematologic {T}oxicity {P}rofiles and
                      {P}rognostic {S}erologic {M}arkers in {P}ostoperative
                      {R}adiochemotherapy {T}reatment for {U}terine {C}ervical
                      {C}ancer.},
      journal      = {Technology in cancer research $\&$ treatment},
      volume       = {21},
      issn         = {1533-0338},
      address      = {Thousand Oaks, CA},
      publisher    = {Sage Publishing},
      reportid     = {DKFZ-2022-01782},
      pages        = {1-12},
      year         = {2022},
      note         = {#LA:E050# /},
      abstract     = {Introduction: In the adjuvant setting for cervical cancer,
                      classical risk factors for postoperative radiochemotherapy
                      have been established. However, data on laboratory changes
                      during therapy and the prognostic value of serological
                      markers are limited and further knowledge is needed to
                      optimize the toxic trimodal regimen. Methods: We
                      retrospectively identified 69 women who underwent weekly
                      postoperative radiochemotherapy with 40 mg/m2 of cisplatin
                      for cervical cancer between 2010 and 2021 at a single
                      center. Laboratory parameters were recorded before, at each
                      cycle and after radiochemotherapy. Kaplan-Meier and log-rank
                      analyses were used to calculate and compare survival, groups
                      were compared using the Mann-Whitney U, χ2, and variance
                      tests. Results: With a median follow-up of 17.7 months, the
                      1- and 5-year local control rates were $94.0\%$ and
                      $73.7\%,$ respectively, with significantly better rates for
                      more chemotherapy cycles and negative resection margins.
                      Only $68.1\%$ of patients completed all cycles. The most
                      common reasons for early discontinuation were persistent
                      asymptomatic leukopenia in women aged ≤ 50 years, and
                      limiting infections in women aged > 50 years. Leukopenia was
                      more likely to occur after the third cycle. Significantly
                      worse survival was observed for post-radiochemotherapy
                      elevated C-reactive-protein and lactate dehydrogenase
                      levels, low pre-radiochemotherapy nutritional index, and
                      raised C-reactive-protein-levels; the latter were also
                      predictable for local control. The Glasgow prognostic score
                      did not reliably predict survival. Conclusion: Incomplete
                      application of simultaneous chemotherapy leads to inferior
                      local control, and age-dependent limiting factors should be
                      identified at an early stage. In addition to classical risk
                      factors, serological markers (C-reactive-protein, lactate
                      dehydrogenase, nutritional index) show prognostic
                      significance.},
      keywords     = {adjuvant treatment (Other) / anemia (Other) /
                      chemoradiation (Other) / gynecological neoplasm (Other) /
                      hematotoxicity (Other) / leukopenia (Other) / systemic
                      inflammatory markers (Other) / thrombocytopenia (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:35950239},
      doi          = {10.1177/15330338221118188},
      url          = {https://inrepo02.dkfz.de/record/181113},
}