TY - JOUR
T1 - Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship
T2 - Results from the randomized PORTEC-2 trial
AU - De Boer, Stephanie M.
AU - Nout, Remi A.
AU - Jurgenliemk-Schulz, Ina M.
AU - Jobsen, Jan J
AU - Lutgens, Ludy C.H.W.
AU - Van Der Steen-Banasik, Elzbieta M.
AU - Mens, Jan Willem M.
AU - Slot, Annerie
AU - Stenfert Kroese, Marika C.
AU - Oerlemans, Simone
AU - Putter, Hein
AU - Verhoeven-Adema, Karen W.
AU - Nijman, Hans W
AU - Creutzberg, Carien L.
PY - 2015
Y1 - 2015
N2 - Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC) survivors. Patients and Methods: In the PORTEC-2 trial, 427 patients with stage I higheintermediate- risk EC were randomly allocated to EBRT or VBT. The 7- and 10-year HRQL questionnaires consisted of EORTC QLQ-C30; subscales for bowel and bladder symptoms; the Impact of Cancer Questionnaire; and 14 questions on comorbidities, walking AIDS, and incontinence pads. Analysis was done using linear mixed models for subscales and (ordinal) logistic regression with random effects for single items. A twosided P value <.01 was considered statistically significant. Results: Longitudinal HRQL analysis showed persisting higher rates of bowel symptoms with EBRT, without significant differences in global health or any of the functioning scales. At 7 years, clinically relevant fecal leakage was reported by 10.6% in the EBRT group, versus 1.8% for VBT (PZ.03), diarrhea by 8.4% versus 0.9% (PZ.04), limitations due to bowel symptoms by 10.5% versus 1.8% (PZ.001), and bowel urgency by 23.3% versus 6.6% (P<.001). Urinary urgency was reported by 39.3% of EBRT patients, 25.5% for VBT, PZ.05. No difference in sexual activity was seen between treatment arms. Long-term impact of cancer scores was higher among the patients who had an EC recurrence or second cancer. Conclusions: More than 7 years after treatment, EBRT patients reported more bowel symptoms with impact on daily activities, and a trend for more urinary symptoms, without impact on overall quality of life or difference in cancer survivorship issues.
AB - Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC) survivors. Patients and Methods: In the PORTEC-2 trial, 427 patients with stage I higheintermediate- risk EC were randomly allocated to EBRT or VBT. The 7- and 10-year HRQL questionnaires consisted of EORTC QLQ-C30; subscales for bowel and bladder symptoms; the Impact of Cancer Questionnaire; and 14 questions on comorbidities, walking AIDS, and incontinence pads. Analysis was done using linear mixed models for subscales and (ordinal) logistic regression with random effects for single items. A twosided P value <.01 was considered statistically significant. Results: Longitudinal HRQL analysis showed persisting higher rates of bowel symptoms with EBRT, without significant differences in global health or any of the functioning scales. At 7 years, clinically relevant fecal leakage was reported by 10.6% in the EBRT group, versus 1.8% for VBT (PZ.03), diarrhea by 8.4% versus 0.9% (PZ.04), limitations due to bowel symptoms by 10.5% versus 1.8% (PZ.001), and bowel urgency by 23.3% versus 6.6% (P<.001). Urinary urgency was reported by 39.3% of EBRT patients, 25.5% for VBT, PZ.05. No difference in sexual activity was seen between treatment arms. Long-term impact of cancer scores was higher among the patients who had an EC recurrence or second cancer. Conclusions: More than 7 years after treatment, EBRT patients reported more bowel symptoms with impact on daily activities, and a trend for more urinary symptoms, without impact on overall quality of life or difference in cancer survivorship issues.
UR - http://www.scopus.com/inward/record.url?scp=84948422768&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2015.08.023
DO - 10.1016/j.ijrobp.2015.08.023
M3 - Article
C2 - 26530748
AN - SCOPUS:84948422768
SN - 0360-3016
VL - 93
SP - 797
EP - 809
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 4
ER -