Prospective analysis of patient-reported late toxicity following pelvic radiotherapy for gynaecological cancer.
OBJECTIVE
As late radiotherapy toxicity impacts negatively on the quality-of-life of cancer survivors and is often under reported, a study was set up to prospectively collect patient-reported data in an unselected series of patients with gynaecological malignancy. Aim 1 - To provide 3 year results for the longitudinal study. Aim 2 - To improve the questionnaire used to collect data by identifying redundant items and modifying for use to collect Common Terminology Criteria for Adverse Events (CTCAE) data.


METHODS
Aim 1 - Patient reported outcome data were collected prospectively by 226 patients before and up to 3 years following radiotherapy for gynaecological cancer using a questionnaire developed to collect LENT subjective data. Aim 2 - A factor analysis was performed to identify which questions gave the most and least information.


RESULTS
Aim 1 - Faecal urgency and incontinence (all grades) peaked at 79% and 24%, respectively at 1 year then settled to 69% and 18% at 3 years, respectively. Urinary urgency (all grades) increased with time and was described in 75% at 3 years. Other symptoms reported at 3 years include diarrhoea in 12%, urinary incontinence in 27% and vaginal dryness in 29%. A third of patients did not feel their sex life had changed following treatment, while a quarter felt that it had. Aim 2 - some questions overlapped and others were non-specific. The questionnaire has subsequently been altered.


CONCLUSIONS
The extent of late toxicity is substantial. This detailed information is important for both patients and clinicians in terms of treatment decisions and follow-up care. The LENT questionnaire provides a feasible tool for capture of this information in the clinic.
The Christie NHS Foundation Trust, Manchester, United Kingdom. lisa.barraclough@christie.nhs.uk
Lisa H
LH
Barraclough
Jacqueline A
JA
Routledge
Damian J J
DJ
Farnell
Meriel P
MP
Burns
Ric
R
Swindell
Jacqueline E
JE
Livsey
Susan E
SE
Davidson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003967:Diarrhea / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005833:Genital Neoplasms, Female / Q000532:radiotherapy*; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010388:Pelvis / Q000528:radiation effects*; D011832:Radiation Injuries / Q000209:etiology*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology; D055815:Young Adult