title: Psychosocial encounters correlates with higher patient-reported functional quality of life in gynecological cancer patients receiving radiotherapy.
abstract: BACKGROUND
  Our objective was to assess longitudinal health-related quality of life (HRQoL) in patients treated with radiotherapy for gynecologic malignancy and assess the relationship of psychosocial encounters on HRQoL.
  
  
  METHODS
  Women with gynecologic malignancy were prospectively enrolled and HRQoL assessed before, during, and after radiotherapy treatment using validated measures. Treatment and demographic information were reviewed. Mixed-effects models were used to assess changes in quality of life (QoL) over time and association of psychologist and social worker encounters with overall QoL as well as subdomains of QoL.
  
  
  RESULTS
  Fifty-two women were enrolled and 41 completed at least one assessment. Fatigue (p=0.008), nausea (p=0.001), feeling ill (p=0.007), and being bothered by side effects (p<0.001) worsened on treatment with subsequent improvement. By follow-up, patients reported increased functional well-being (FWB) with significant decrease in worry (p=0.003), increase in enjoyment of things usually done for fun (p=0.003) and increase in contentment (p=0.047). Twenty-three patients had at least one interaction with a social worker or psychologist during treatment. Each additional interaction was associated with a 2.12 increase in FWB score from before to after treatment (p=0.002), and 1.74 increase from on to after treatment (p= 0.011). Additional interactions were not significantly associated with changes in overall FACT score (p=0.056) or SWB (p=0.305).
  
  
  CONCLUSIONS
  Patient-reported HRQoL significantly worsened during radiotherapy treatment with subsequent improvement, affirming transiency of treatment-induced toxicities. Our preliminary study suggests that clinically-recommended psychological and social work interventions have potential value with respect to improving patient QoL during radiotherapy. Larger studies are needed to validate our findings.
authors: Department of Radiation Oncology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA. penny.fang@post.harvard.edu.
authors: Penny
authors: P
authors: Fang
authors: Department of Biostatistics and Epidemiology, University of Pennsylvania, PCAM/TRC 4 West, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA. kaystan@mail.med.upenn.edu.
authors: Kay See
authors: KS
authors: Tan
authors: Department of Radiation Oncology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA. surbhi.grover@uphs.upenn.edu.
authors: Surbhi
authors: S
authors: Grover
authors: Department of Radiation Oncology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA. Mary.Mcfadien@uphs.upenn.edu.
authors: Mary K
authors: MK
authors: McFadien
authors: Department of Biostatistics and Epidemiology, University of Pennsylvania, PCAM/TRC 4 West, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA. atroxel@mail.med.upenn.edu.
authors: Andrea B
authors: AB
authors: Troxel
authors: Department of Radiation Oncology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA. lin@xrt.upenn.edu.
authors: Lilie
authors: L
authors: Lin
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000523:psychology* / Q000532:radiotherapy*; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated; D011795:Surveys and Questionnaires
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