PURPOSE: The purposes of this analysis are to report a modern series of severe @entity344 effects after definitive chemoradiotherapy in the treatment of locally advanced cervical @entity5 at our institution and to review the existing literature on factors that contribute to toxic effects and preventive strategies and management. METHODS: Our institution's cervical @entity5 cohort was evaluated for @entity1 with late grade 3 to 4 @entity344 effects who were retrospectively reviewed for clinical or dosimetric parameters that could have contributed to late toxic effects. A review of the published literature was performed to identify factors associated with late toxic effects, prophylactic agents, and corrective therapy. FINDINGS: Five of 85 @entity1 were identified as having late grade 3 to 4 @entity344 effects with a median follow-up of 13.3 months. Two of 5 @entity1 developed late grade 3 toxic effects, and 3 of 5 developed late grade 4 toxic effects. Three of the 5 @entity1 reviewed ultimately required permanent colostomies. Cumulative median dose (in equivalent dose in 2-Gy fractions) of clinical target volume to the hottest 90% was 107.2 Gy, rectal dose to the hottest 2 cc (D2cc) was 81.7 Gy, sigmoid D2cc was 61.7 Gy, and bladder D2cc was 79.5 Gy. No @entity1 had evidence of disease recurrence in the pelvis. One @entity1 developed @entity66 in the suprarenal gland and was successfully salvaged with adrenalectomy. IMPLICATIONS: Despite its risk of toxic effects, intracavitary brachytherapy remains a critical component of the treatment of locally advanced cervical @entity5 . Even with modern radiotherapy planning and delivery techniques, extra attention is warranted to continue to strive for optimal outcomes.

Severe XXXX in the Era of Image-Guided High-Dose-Rate Intracavitary Brachytherapy for @entity5 .

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity344 :: ('MESH:D005767', 'Disease') :: ['gastrointestinal toxic'] @entity66 :: ('MESH:D004194', 'Disease') :: ['oligometastatic disease']
@entity344 :: (MESH:D005767,Disease) :: ['Gastrointestinal Complications']
