Five-year quality of life of endometrial cancer patients treated in the randomised Post Operative Radiation Therapy in Endometrial Cancer (PORTEC-2) trial and comparison with norm data

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• 作者：Remi A. Nout ; Hein Putter ; Ina M. J¨¹rgenliemk-Schulz ; Jan J. Jobsen ; Ludy C.H.W. Lutgens ; Elzbieta M. van der Steen-Banasik ; Jan Willem M. Mens ; Annerie Slot ; Marika C. Stenfert Kroese ; Hans W. Nijman ; Lonneke V. van de Poll-Franse ; Carien L. Creutzberg
• 关键词：Randomised trial ; Quality of life ; Radiotherapy ; Brachytherapy ; Endometrial carcinoma ; Toxicity
• 刊名：European Journal of Cancer
• 出版年：2012
• 出版时间：July, 2012
• 年：2012
• 卷：48
• 期：11
• 页码：1638-1648
• 全文大小：1556 K

文摘

<h4 class=""h4"">Backgroundh4>The PORTEC-2 trial showed efficacy and reduced side-effects of vaginal brachytherapy (VBT) compared with external beam pelvic radiotherapy (EBRT) for patients with high-intermediate risk endometrial cancer. The current analysis was done to evaluate long-term health related quality of life (HRQL), and compare HRQL of patients to an age-matched norm population.<h4 class=""h4"">Methodsh4>

Patients were randomly allocated to EBRT (n = 214) or VBT (n = 213). HRQL was assessed using EORTC QLQ-C30 and subscales from PR25 and OV28 (bladder, bowel, sexual symptoms); and compared to norm data.<h4 class=""h4"">Findingsh4>

Median follow-up was 65 months; 348 (81 % ) patients were evaluable for HRQL (EBRT n = 166, VBT n = 182). At baseline, patient functioning was at lowest level, increasing during and after radiotherapy to reach a plateau after 12 months, within range of scores of the norm population. VBT patients reported better social functioning (p = 0.005) and lower symptom scores for diarrhoea, faecal leakage, need to stay close to a toilet and limitation in daily activities due to bowel symptoms (p ? 0.001), compared to EBRT. There were no differences in sexual functioning or symptoms between the treatment groups; however, sexual functioning was lower and sexual symptoms more frequent in both treatment groups compared to the norm population.<h4 class=""h4"">Interpretationh4>

Patients who received EBRT reported clinically relevant higher levels of bowel symptoms and related limitations in daily activities with lower social functioning, 5 years after treatment. VBT provides a better HRQL, which remained similar to that of an age-matched norm population, except for sexual symptoms which were more frequent in both treatment groups.