J Gynecol Oncol.  2011 Sep;22(3):152-160. 10.3802/jgo.2011.22.3.152.

Health-related quality of life and late morbidity in concurrent chemoradiation and radiotherapy alone in patients with locally advanced cervical carcinoma

• Berveling
• Langendijk JA
• Beukema JC
• Mourits MJ
• Reyners AK
• Pras E

• KMID: 2055702
• DOI: http://doi.org/10.3802/jgo.2011.22.3.152

Abstract

OBJECTIVE
Concurrent chemoradiation has improved survival of patients with cervical carcinoma. However, follow-up of randomized studies is relatively short and data on long term toxicity are scarce, as is information on their health-related quality of life. This study assesses and compares incidences of late side-effects among patients treated with radiotherapy or chemoradiation using two toxicity scoring systems, and investigates impact on health-related quality of life.
METHODS
Between 1985 and 1993, 114 patients underwent radiotherapy (n=39) or chemoradiation (n=75) for stage IIA-IVB cervical carcinoma. Late side-effects were scored retrospectively by reviewing medical charts using standardised checklists, focusing on bladder- and intestinal side effects. Health-related quality of life was assessed once using the EORTC QLQ-C30.
RESULTS
No significant differences in late treatment-related side-effects between radiotherapy and chemoradiation groups were found. Grade > or = 2 toxicity was found in 33% (bladder), and in 6% (bowel). Only 1.8% had both grade 3-4 toxicity. Bladder syndrome with high urinary frequency, urine incontinence and small bowel toxicity had a significant impact on health-related quality of life.
CONCLUSION
Grade 2 are relatively frequent late side effects in curatively treated patients, but are not enhanced by the addition of chemotherapy. Their negative impact on health-related quality of life stresses the importance of new radiation techniques, aiming at reduction of these side effects.

Keyword

Cervical carcinoma; Concurrent radiochemotherapy; Late treatment-related morbidity; Radiotherapy

MeSH Terms

Checklist
Chemoradiotherapy
Follow-Up Studies
Humans
Incidence
Quality of Life
Retrospective Studies
Urinary Bladder

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