title: Health-related quality of life and late morbidity in concurrent chemoradiation and radiotherapy alone in patients with locally advanced cervical carcinoma.
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 ≥ 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.
  
  
  CONCLUSIONS
  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.
authors: Department of Radiation Oncology, University Medical Center Groningen/University of Groningen, Groningen, The Netherlands.
authors: Maaike J
authors: MJ
authors: Berveling
authors: Johannes A
authors: JA
authors: Langendijk
authors: Jannet C
authors: JC
authors: Beukema
authors: Marian J E
authors: MJ
authors: Mourits
authors: Anna K L
authors: AK
authors: Reyners
authors: Elisabeth
authors: E
authors: Pras