title: Quality of life and acute toxicity of radiotherapy in women with gynecologic cancer: a prospective longitudinal study.
abstract: OBJECTIVE
  To investigate the incidence of acute toxicity of radiotherapy, evaluate quality of life (QOL) and identify its predictors in a cohort of gynecologic cancer patients.
  
  
  METHODS
  A longitudinal prospective study was conducted including 107 women between the ages of 18 and 75 years with cervical or endometrial cancer. Acute toxicity was evaluated according to the Common Toxicity Criteria and the Radiotherapy Oncology Group toxicity criteria. QOL was measured with World Health Organization's Quality of Life instrument-abbreviated version (WHOQOL-BREF) before and at completion of radiotherapy and during the first clinical follow-up visit. QOL scores were assessed by ANOVA for repeat measures. Percentage variation of QOL scores from the time before radiotherapy to the first clinical visit was compared with control variables by the Wilcoxon test. Multiple linear regression analysis was used to identify predictors of QOL.
  
  
  RESULTS
  Ninety-five women completed the three QOL assessments. The incidence of acute toxicity was 93.5% and the most common complaint was lower gastrointestinal (79.6%). A significant increase in QOL scores was observed in the physical and psychological domains, as well as general health and overall QOL. Upper gastrointestinal toxicity (p = 0.043) and surgery (p = 0.027) negatively affected general health, while improvement in vaginal bleeding (p = 0.047) positively influenced general health.
  
  
  CONCLUSIONS
  A high incidence of acute toxicity of radiotherapy was observed. At the completion of treatment, QOL improved in gynecologic cancer patients. Women with upper gastrointestinal toxicity and history of surgery are at risk for having a worse QOL.
authors.affiliation: Department of Gynecology and Obstetrics, Universidade Estadual de Campinas, School of Medicine, Campinas, SP, Brazil.
authors.forename: Ana Francisca
authors.initials: AF
authors.lastname: Vaz
authors.forename: Aarão Mendes
authors.initials: AM
authors.lastname: Pinto-Neto
authors.forename: Délio Marques
authors.initials: DM
authors.lastname: Conde
authors.forename: Lúcia
authors.initials: L
authors.lastname: Costa-Paiva
authors.forename: Sirlei Siani
authors.initials: SS
authors.lastname: Morais
authors.forename: Sérgio Barros
authors.initials: SB
authors.lastname: Esteves
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012923:Social Class; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*; D055815:Young Adult