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

• Published in: Journal of gynecologic oncology Vol. 22; no. 3; pp. 152 - 160
• Main Authors: Berveling, Maaike J, Langendijk, Johannes A, Beukema, Jannet C, Mourits, Marian J E, Reyners, Anna K L, Pras, Elisabeth
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Gynecologic Oncology and Colposcopy 01.09.2011; 대한부인종양학회
• Subjects: Original; 산부인과학; Concurrent radiochemotherapy; Cervical carcinoma; Radiotherapy; Late treatment-related morbidity
• ISSN: 2005-0380; 2005-0399
• DOI: 10.3802/jgo.2011.22.3.152

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. 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. No significant differences in late treatment-related side-effects between radiotherapy and chemoradiation groups were found. Grade ≥ 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. 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.