Association of persistent morbidity after radiotherapy with quality of life in locally advanced cervical cancer survivors.

Autor: Spampinato S; Danish Center for Particle Therapy, Aarhus University Hospital, 8200 Aarhus, Denmark. Electronic address: sofspa@rm.dk., Tanderup K; Danish Center for Particle Therapy, Aarhus University Hospital, 8200 Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark. Electronic address: karitand@rm.dk., Lindegaard JC; Department of Oncology, Aarhus University Hospital, 8200 Aarhus, Denmark. Electronic address: jacob.lindegaard@auh.rm.dk., Schmid MP; Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria. Electronic address: maximilian.schmid@akhwien.at., Sturdza A; Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria. Electronic address: alina.sturdza@akhwien.at., Segedin B; Department of Radiotherapy, Institute of Oncology, 1000 Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia. Electronic address: bsegedin@onko-i.si., Jürgenliemk-Schulz IM; Department of Radiation Oncology, University Medical Centre Utrecht, 3584 CX Utrecht, the Netherlands. Electronic address: I.M.Schulz@umcutrecht.nl., De Leeuw A; Department of Radiation Oncology, University Medical Centre Utrecht, 3584 CX Utrecht, the Netherlands. Electronic address: astrid.a.c.deleeuw@gmail.com., Bruheim K; Department of Oncology, Oslo University Hospital, 0450 Oslo, Norway. Electronic address: uxkjuh@ous-hf.no., Mahantshetty U; Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai and Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh 530053, India. Electronic address: drumeshm@gmail.com., Chargari C; Department of Radiation Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France. Electronic address: Cyrus.CHARGARI@gustaveroussy.fr., Rai B; Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. Electronic address: bhavana1035@gmail.com., Cooper R; Leeds Cancer Centre, St James's University Hospital, Leeds LS9 7LP, United Kingdom. Electronic address: Rachel.cooper1@nhs.net., van der Steen-Banasik E; Department of Radiotherapy, Radiotherapiegroep Arnhem, 6815 AD Arnhem, the Netherlands. Electronic address: E.vanderSteen-Banasik@radiotherapiegroep.nl., Sundset M; Clinic of Oncology and Women's Clinic, St. Olavs Hospital, 7030 Trondheim, Norway. Electronic address: marit.sundset@stolav.no., Wiebe E; Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton AB T6G 1Z2, Canada. Electronic address: Ericka.Wiebe@albertahealthservices.ca., Villafranca E; Department of Radiation Oncology, Hospital of Navarra, 31008 Pamplona, Navarra, Spain. Electronic address: elena.villafranca.iturre@cfnavarra.es., Van Limbergen E; Department of Radiation Oncology, University Hospital Leuven, 3000 Leuven, Belgium. Electronic address: erik.vanlimbergen@uz.kuleuven.ac.be., Pieters BR; Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, 1081 HV Amsterdam, the Netherlands. Electronic address: b.r.pieters@amc.uva.nl., Tee Tan L; Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, United Kingdom. Electronic address: litee.tan@addenbrookes.nhs.uk., Lutgens LCHW; Maastricht Radiation Oncology (MAASTRO) clinic, 6229 ET Maastricht, the Netherlands. Electronic address: ludy.lutgens@maastro.nl., Hoskin P; Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood HA6 2RN, United Kingdom. Electronic address: peterhoskin@nhs.net., Smet S; Department of Radiation Oncology, Algemeen Ziekenhuis Turnhout, 2300 Turnhout, Belgium. Electronic address: stephanie_smet99@hotmail.com., Pötter R; Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria. Electronic address: Richard.Poetter@akhwien.at., Nout R; Department of Clinical Oncology, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands. Electronic address: r.nout@erasmusmc.nl., Chopra S; Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai 410210, India. Electronic address: supriyasastri@gmail.com., Kirchheiner K; Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria. Electronic address: Kathrin.Kirchheiner@akhwien.at.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2023 Apr; Vol. 181, pp. 109501. Date of Electronic Publication: 2023 Jan 30.
DOI: 10.1016/j.radonc.2023.109501
Abstrakt: Purpose: To quantify the association of persistent morbidity with different aspects of quality of life (QOL) in locally advanced cervical cancer (LACC) survivors.
Material and Methods: Longitudinal outcome from the EMBRACE-I study was evaluated. Patient-reported symptoms and QOL were prospectively scored (EORTC-C30/CX24) at baseline and regular follow-ups. Physician-assessed symptoms were also reported (CTCAEv.3). Persistent symptoms were defined if present in at least half of the follow-ups. QOL items were linearly transformed into a continuous scale. Linear mixed-effects models (LMM) were applied to evaluate and quantify the association of persistent symptoms with QOL. Overall QOL deterioration was evaluated by calculating the integral difference in QOL over time obtained with LMM for patients without and with persistent symptoms.
Results: Out of 1416 patients enrolled, 741 with baseline and ≥ 3 late follow-ups were analyzed (median 59 months). Proportions of persistent EORTC symptoms ranged from 21.8 % to 64.9 % (bowel control and tiredness). For CTCAE the range was 11.3-28.6 % (limb edema and fatigue). Presence of any persistent symptom was associated with QOL, although with varying magnitude. Role functioning and Global health/QOL were the most impaired aspects. Fatigue and pain showed large differences, with reductions of around 20 % for most of the QOL aspects. Among organ-related symptoms, abdominal cramps showed the largest effect.
Conclusion: Persistent symptoms are associated with QOL reductions in LACC survivors. Organ-related symptoms showed smaller differences than general symptoms such as fatigue and pain. In addition to optimizing treatment to minimize organ-related morbidity, effort should be directed towards a more comprehensive and targeted morbidity management.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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