title: Prospective study of symptom assessment among patients with cervical cancer during concurrent chemoradiotherapy with weekly cisplatin or every-3-week cisplatin and 5-fluorouracil.
abstract: OBJECTIVE
  In this prospective study, symptoms were assessed in patients with locally advanced cervical cancer undergoing concurrent chemoradiotherapy (CTRT) with either weekly cisplatin (WP) or every-3-week cisplatin/5-fluorouracil (PF).
  
  
  METHODS
  Patients with 1994 International Federation of Gynecology and Obstetrics stage IIB to IVA disease, biopsy-proven involved pelvic nodes, or gross tumor size greater than 5 cm were eligible. Patients requiring paraaortic radiotherapy were excluded. With the use of a modified Edmonton Symptom Assessment Scale, patients reported symptom severity on an 11-point scale 3 times per week during CTRT and at the first follow-up. The Wilcoxon rank sum test and multilevel mixed-effects linear regression were used to assess the effect of chemotherapy regimen on symptoms.
  
  
  RESULTS
  Among the 52 patients included in the final analysis, 37 received WP, 13 received PF, and 2 received 1 cycle of PF followed by WP. Overall compliance with completion of Edmonton Symptom Assessment Scale questionnaires was 75%. There were significant differences in symptom scores for well-being, anorexia, fatigue, diarrhea, and stomatitis favoring the WP regimen. All symptoms except diarrhea were stable and of low intensity in the WP group. In the PF group, symptoms had a cyclical pattern with an initial rise followed by a gradual fall during the 3-week period after chemotherapy. For the 29 patients (56%) who completed the follow-up surveys, scores for all symptoms improved to baseline levels 4 to 6 weeks after treatment.
  
  
  CONCLUSIONS
  This analysis provides important patient-reported data regarding the rates and timing of acute symptoms during CTRT that can help clinicians better manage symptoms that impact patients' quality of life.
authors.affiliation: Departments of *Radiation Oncology, and †Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Anna
authors.initials: A
authors.lastname: Likhacheva
authors.forename: Anuja
authors.initials: A
authors.lastname: Jhingran
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
authors.forename: Charlotte
authors.initials: C
authors.lastname: Sun
authors.forename: Marianne
authors.initials: M
authors.lastname: Sam
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Eifel
mesh_terms: D000328:Adult; D000368:Aged; D000855:Anorexia / Q000139:chemically induced; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001007:Anxiety / Q000139:chemically induced; D002277:Carcinoma / Q000188:drug therapy* / Q000532:radiotherapy; D059248:Chemoradiotherapy / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D003863:Depression / Q000139:chemically induced; D003967:Diarrhea / Q000139:chemically induced; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010146:Pain / Q000139:chemically induced; D011446:Prospective Studies; D013280:Stomatitis / Q000139:chemically induced; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D055815:Young Adult
chemical_list: D000964:Antimetabolites, Antineoplastic; D002945:Cisplatin; D005472:Fluorouracil