Health related quality of life and patient reported symptoms before and during definitive radio(chemo)therapy using image-guided adaptive brachytherapy for locally advanced cervical cancer and early recovery — A mono-institutional prospective study

• Published in: Gynecologic oncology Vol. 136; no. 3; pp. 415 - 423
• Main Authors: Kirchheiner, Kathrin, Nout, Remi A, Czajka-Pepl, Agnieszka, Ponocny-Seliger, Elisabeth, Sturdza, Alina E, Dimopoulos, Johannes C, Dörr, Wolfgang, Pötter, Richard
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2015
• Subjects: Adult; Aged; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Brachytherapy - adverse effects; Brachytherapy - methods; Cervical cancer; Chemoradiotherapy - adverse effects; Chemoradiotherapy - methods; Cisplatin - adverse effects; Cisplatin - therapeutic use; Definitive radio(chemo)therapy; Female; Health Status; Health Status Indicators; Health-related quality of life; Hematology, Oncology and Palliative Medicine; Humans; Image-guided adaptive brachytherapy; Middle Aged; Neoplasm Staging; Obstetrics and Gynecology; Patient reported symptoms; Prospective Studies; Quality of Life; Radiotherapy, Image-Guided - adverse effects; Radiotherapy, Image-Guided - methods; Recovery of Function; Surveys and Questionnaires; Treatment Outcome; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - psychology; Uterine Cervical Neoplasms - therapy; Health-related quality of life; Image-guided adaptive brachytherapy; Definitive radio(chemo)therapy; Patient reported symptoms; Cervical cancer
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2014.10.031

Abstract Objective To evaluate health-related quality of life (HR-QoL) and patient reported symptoms (PRS) before, during and early after treatment with external-beam radiotherapy (EBRT), chemotherapy and image-guided adaptive brachytherapy (IGABT) for locally advanced cervical cancer. Methods In fifty consecutive patients, HR-QoL and PRS were prospectively assessed with the EORTC-QLQ-C30 + CX24 questionnaire prior to and during treatment, one week after IGABT and three months thereafter. HR-QoL was compared to an age-matched, female normative reference population. Prevalence rates of individual PRS are presented and defined as “substantial”, if reported as “quite a bit” or “very much”. Results Global health status and physical and role functioning show a highly significant decline during treatment (p ≤ 0.001), before returning to near the baseline levels three months after end of treatment. Compared to the reference population, the global health status and emotional and role functioning remain impaired. The most frequently reported substantial PRS during active treatment are: fatigue (78%), diarrhea (68%), urinary frequency (60%) and nausea (54%); these recover to some degree three months after end of treatment. However, fatigue remains increased (50%) and an onset of hot flashes (44%), sexual worries (38%) and limb edema (22%) is observed. Conclusions Several impairments in HR-QoL and PRS were found during definitive radio(chemo)therapy with IGABT, with different patterns of progress over time and signs of recovery three months thereafter, although some aspects of functional HR-QoL remain impaired. These findings support a comprehensive patients' counseling on what to expect and how to organize professional, social and family life and plan additional support during this period.