title: 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.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands. r.a.nout@lumc.nl
authors.forename: Remi A
authors.initials: RA
authors.lastname: Nout
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.forename: Ina M
authors.initials: IM
authors.lastname: Jürgenliemk-Schulz
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Jobsen
authors.forename: Ludy C H W
authors.initials: LC
authors.lastname: Lutgens
authors.forename: Elzbieta M
authors.initials: EM
authors.lastname: van der Steen-Banasik
authors.forename: Jan Willem M
authors.initials: JW
authors.lastname: Mens
authors.forename: Annerie
authors.initials: A
authors.lastname: Slot
authors.forename: Marika C
authors.initials: MC
authors.lastname: Stenfert Kroese
authors.forename: Hans W
authors.initials: HW
authors.lastname: Nijman
authors.forename: Lonneke V
authors.initials: LV
authors.lastname: van de Poll-Franse
authors.forename: Carien L
authors.initials: CL
authors.lastname: Creutzberg
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects; D003967:Diarrhea / Q000453:epidemiology; D016889:Endometrial Neoplasms / Q000523:psychology* / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D012725:Sexual Behavior