Long-term toxicity and health-related quality of life after adjuvant chemoradiation therapy or radiation therapy alone for high-risk endometrial cancer in the randomized PORTEC-3 trial
| Autor: | Ina M. Jürgenliemk-Schulz, Ludy C.H.W. Lutgens, Marie Helene Baron, V. Do, Karen W Verhoeven-Adema, C. Post, Nelleke Ottevanger, Carien L. Creutzberg, Christine Haie-Meder, Jonathan A. Ledermann, Susan Brooks, Geraldine Goss, Linda Mileshkin, Anthony Fyles, Paul Bessette, Melanie E Powell, Roldano Fossati, Mary McCormack, Stephanie M. de Boer, Henry C Kitchener, Andrea Lissoni, Alexandra Leary, Vincent T.H.B.M. Smit, Romerai D'Amico, Amanda Feeney, Dionyssios Katsaros, Remi A. Nout, Hans W. Nijman, Hein Putter, Prafull Ghatage, Pearly Khaw |
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| Přispěvatelé: | Radiotherapie, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Translational Immunology Groningen (TRIGR), Targeted Gynaecologic Oncology (TARGON), Post, C, de Boer, S, Powell, M, Mileshkin, L, Katsaros, D, Bessette, P, Haie-Meder, C, Ottevanger, N, Ledermann, J, Khaw, P, D'Amico, R, Fyles, A, Baron, M, Kitchener, H, Nijman, H, Lutgens, L, Brooks, S, Jürgenliemk-Schulz, I, Feeney, A, Goss, G, Fossati, R, Ghatage, P, Leary, A, Do, V, Lissoni, A, Mccormack, M, Nout, R, Verhoeven-Adema, K, Smit, V, Putter, H, Creutzberg, C |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Sexual Behavior medicine.medical_treatment Population chemotherapy chemoradiotherapy 030218 nuclear medicine & medical imaging 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Endometrial cancer Quality of life Internal medicine medicine Humans Radiology Nuclear Medicine and imaging education Adverse effect radiotherapy Aged Aged 80 and over education.field_of_study Radiation business.industry toxicity Common Terminology Criteria for Adverse Events Chemoradiotherapy Adjuvant Middle Aged Physical Functional Performance medicine.disease Carboplatin Endometrial Neoplasms Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] Radiation therapy quality of life Oncology chemistry 030220 oncology & carcinogenesis Toxicity Female business |
| Zdroj: | International Journal of Radiation Oncology-Biology-Physics, 109(4), 975-986. ELSEVIER SCIENCE INC International Journal of Radiation Oncology, Biology, Physics, 109, 975-986 International Journal of Radiation Oncology Biology Physics, 109(4), 975-986. Elsevier Science International Journal of Radiation Oncology, Biology, Physics, 109(4), 975-986. ELSEVIER SCIENCE INC International Journal of Radiation Oncology, Biology, Physics, 109, 4, pp. 975-986 International journal of radiation oncology, biology, physics, 109(4), 975-986. Elsevier |
| ISSN: | 0360-3016 |
| Popis: | Contains fulltext : 232064.pdf (Publisher’s version ) (Open Access) PURPOSE: The survival results of the PORTEC-3 trial showed a significant improvement in both overall and failure-free survival with chemoradiation therapy versus pelvic radiation therapy alone. The present analysis was performed to compare long-term adverse events (AE) and health-related quality of life (HRQOL). METHODS AND MATERIALS: In the study, 660 women with high-risk endometrial cancer were randomly assigned to receive chemoradiation therapy (2 concurrent cycles of cisplatin followed by 4 cycles of carboplatin/paclitaxel) or radiation therapy alone. Toxicity was graded using Common Terminology Criteria for Adverse Events, version 3.0. HRQOL was measured using EORTC QLQ-C30 and CX24/OV28 subscales and compared with normative data. An as-treated analysis was performed. RESULTS: Median follow-up was 74.6 months; 574 (87%) patients were evaluable for HRQOL. At 5 years, grade ≥2 AE were scored for 78 (38%) patients who had received chemoradiation therapy versus 46 (24%) who had received radiation therapy alone (P = .008). Grade 3 AE did not differ significantly between the groups (8% vs 5%, P = .18) at 5 years, and only one new late grade 4 toxicity had been reported. At 3 and 5 years, sensory neuropathy toxicity grade ≥2 persisted after chemoradiation therapy in 6% (vs 0% after radiation therapy, P < .001) and more patients reported significant tingling or numbness at HRQOL (27% vs 8%, P < .001 at 3 years; 24% vs 9%, P = .002 at 5 years). Up to 3 years, more patients who had chemoradiation therapy reported limb weakness (21% vs 5%, P < .001) and lower physical (79 vs 87, P < .001) and role functioning (78 vs 88, P < .001) scores. Both treatment groups reported similar long-term global health/quality of life scores, which were better than those of the normative population. CONCLUSIONS: This study shows a long-lasting, clinically relevant, negative impact of chemoradiation therapy on toxicity and HRQOL, most importantly persistent peripheral sensory neuropathy. Physical and role functioning impairments were seen until 3 years. These long-term data are essential for patient information and shared decision-making regarding adjuvant chemotherapy for high-risk endometrial cancer. |
| Databáze: | OpenAIRE |
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