title: Health related quality of life and patient reported symptoms before and during definitive radio(chemo)therapy using image-guided adaptive brachytherapy for locally advanced cervical cancer and early recovery - a mono-institutional prospective study.
abstract: OBJECTIVE
  To evaluate health-related quality of life (HR-QoL) and patient reported symptoms (PRS) before, during and early after treatment with external-beam radiotherapy (EBRT), chemotherapy and image-guided adaptive brachytherapy (IGABT) for locally advanced cervical cancer.
  
  
  METHODS
  In fifty consecutive patients, HR-QoL and PRS were prospectively assessed with the EORTC-QLQ-C30+CX24 questionnaire prior to and during treatment, one week after IGABT and three months thereafter. HR-QoL was compared to an age-matched, female normative reference population. Prevalence rates of individual PRS are presented and defined as "substantial", if reported as "quite a bit" or "very much".
  
  
  RESULTS
  Global health status and physical and role functioning show a highly significant decline during treatment (p≤0.001), before returning to near the baseline levels three months after end of treatment. Compared to the reference population, the global health status and emotional and role functioning remain impaired. The most frequently reported substantial PRS during active treatment are: fatigue (78%), diarrhea (68%), urinary frequency (60%) and nausea (54%); these recover to some degree three months after end of treatment. However, fatigue remains increased (50%) and an onset of hot flashes (44%), sexual worries (38%) and limb edema (22%) is observed.
  
  
  CONCLUSIONS
  Several impairments in HR-QoL and PRS were found during definitive radio(chemo)therapy with IGABT, with different patterns of progress over time and signs of recovery three months thereafter, although some aspects of functional HR-QoL remain impaired. These findings support a comprehensive patients' counseling on what to expect and how to organize professional, social and family life and plan additional support during this period.
authors.affiliation: Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Austria. Electronic address: kathrin.kirchheiner@meduniwien.ac.at.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Kirchheiner
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Center, The Netherlands.
authors.forename: Remi A
authors.initials: RA
authors.lastname: Nout
authors.affiliation: Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Austria.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Czajka-Pepl
authors.affiliation: Department of Psychology, Sigmund Freud Private University, Vienna, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Ponocny-Seliger
authors.affiliation: Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Austria.
authors.forename: Alina E
authors.initials: AE
authors.lastname: Sturdza
authors.affiliation: Department of Radiation Oncology, Metropolitan Hospital, Athens, Greece.
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Dimopoulos
authors.affiliation: Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dörr
authors.affiliation: Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria.
authors.forename: Richard
authors.initials: R
authors.lastname: Pötter
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D059248:Chemoradiotherapy / Q000009:adverse effects* / Q000379:methods; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011788:Quality of Life; D061089:Radiotherapy, Image-Guided / Q000009:adverse effects* / Q000379:methods; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000523:psychology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Cervical cancer; Definitive radio(chemo)therapy; Health-related quality of life; Image-guided adaptive brachytherapy; Patient reported symptoms