TY - JOUR
T1 - Health-Related Quality of Life in Locally Advanced Cervical Cancer Patients after Definitive Chemoradiation Therapy Including Image Guided Adaptive Brachytherapy: An Analysis from the EMBRACE Study
AU - Kirchheiner, Kathrin
AU - Pötter, Richard
AU - Tanderup, Kari
AU - Lindegaard, Jacob C.
AU - Haie-Meder, Christine
AU - Petrič, Primož
AU - Mahantshetty, Umesh
AU - Jürgenliemk-Schulz, Ina M.
AU - Rai, Bhavana
AU - Cooper, Rachel
AU - Dörr, Wolfgang
AU - Nout, Remi A.
AU - Fokdal, Lars
AU - van der Steen Banasik, Elzbieta
AU - Dumas, Isabelle
AU - Chargari, Cyrus
AU - van Limbergen, Erik
AU - Segedin, Barbara
AU - Hudej, Robert
AU - Erickson, Beth
AU - Hoskin, Peter
AU - Lowe, Gerry
AU - Swamidas, Jamema
AU - Shrivastava, Shyam Kishore
AU - de Leeuw, Astrid
AU - Lutgens, Ludy C. H. W.
AU - Hadjiev, Janaki
AU - Bownes, Peter
AU - Sundset, Marit
AU - Bruheim, Kjersti
AU - Hellebust, Taran Paulsen
AU - Huang, Fleur
AU - Menon, Geetha
AU - Villafranca, Elena
AU - Oinam, Arun S.
AU - Tan, Li Tee
AU - Bachand, Francois
AU - Jacobson, Geraldine
AU - Anttila, Maarit
AU - Pieters, Bradley
AU - EMBRACE Collaborative Group
PY - 2016
Y1 - 2016
N2 - Purpose This study analyzed functioning and symptom scores for longitudinal quality of life (QoL) from patients with locally advanced cervical cancer who underwent definitive chemoradiation therapy with image guided adaptive brachytherapy in the EMBRACE study. Methods and Materials In total, 744 patients at a median follow-up of 21 months were included. QoL was prospectively assessed using European Organization for Research and Treatment of Cancer Quality of Life core module 30 (EORTC QLQ-C30) and EORTC cervical cancer module 24 (CX24) questionnaires at baseline, then every 3 months during the first year, every 6 months in the second and third years, and finally yearly thereafter in patients with no evidence of disease. Outcomes were evaluated over time and compared to those from an age-matched female reference population. Results General QoL and emotional and social functioning were impaired at baseline but improved during the first 6 months after treatment, to reach a level comparable to that of the reference population, whereas cognitive functioning remained impaired. Both social and role functioning showed the lowest scores at baseline but which increased after treatment to reach a plateau at 6 months and then declined slightly at 3 and 4 years. The overall symptom experience was elevated at baseline and decreased to a level within the range of that of the reference population. Similarly, tumor-related symptoms (eg, pain, appetite loss, and constipation), which were present before treatment, decreased substantially at the first follow-up after treatment. Several treatment-related symptoms developed either immediately after and persisted over time (diarrhea, menopausal symptoms, peripheral neuropathy, and sexual functioning problems) or developed gradually after treatment (lymphedema and dyspnea). Conclusions This longitudinal prospective QoL analysis showed that patients' general QoL and functioning were impaired before treatment compared to those of reference data. Several tumor-related symptoms resolved after treatment, and functioning and general QoL returned to that of the level of the reference population, indicating a transient impact of diagnosis and treatment. However, several treatment-related symptoms and problems did develop and persist, either immediately or gradually after treatment.
AB - Purpose This study analyzed functioning and symptom scores for longitudinal quality of life (QoL) from patients with locally advanced cervical cancer who underwent definitive chemoradiation therapy with image guided adaptive brachytherapy in the EMBRACE study. Methods and Materials In total, 744 patients at a median follow-up of 21 months were included. QoL was prospectively assessed using European Organization for Research and Treatment of Cancer Quality of Life core module 30 (EORTC QLQ-C30) and EORTC cervical cancer module 24 (CX24) questionnaires at baseline, then every 3 months during the first year, every 6 months in the second and third years, and finally yearly thereafter in patients with no evidence of disease. Outcomes were evaluated over time and compared to those from an age-matched female reference population. Results General QoL and emotional and social functioning were impaired at baseline but improved during the first 6 months after treatment, to reach a level comparable to that of the reference population, whereas cognitive functioning remained impaired. Both social and role functioning showed the lowest scores at baseline but which increased after treatment to reach a plateau at 6 months and then declined slightly at 3 and 4 years. The overall symptom experience was elevated at baseline and decreased to a level within the range of that of the reference population. Similarly, tumor-related symptoms (eg, pain, appetite loss, and constipation), which were present before treatment, decreased substantially at the first follow-up after treatment. Several treatment-related symptoms developed either immediately after and persisted over time (diarrhea, menopausal symptoms, peripheral neuropathy, and sexual functioning problems) or developed gradually after treatment (lymphedema and dyspnea). Conclusions This longitudinal prospective QoL analysis showed that patients' general QoL and functioning were impaired before treatment compared to those of reference data. Several tumor-related symptoms resolved after treatment, and functioning and general QoL returned to that of the level of the reference population, indicating a transient impact of diagnosis and treatment. However, several treatment-related symptoms and problems did develop and persist, either immediately or gradually after treatment.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84960981708&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/26876955
U2 - 10.1016/j.ijrobp.2015.12.363
DO - 10.1016/j.ijrobp.2015.12.363
M3 - Article
C2 - 26876955
VL - 94
SP - 1088
EP - 1098
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
SN - 0360-3016
IS - 5
ER -