title: Assessing the Quality of Life in Patients With Endometrial Cancer Treated With Adjuvant Radiotherapy.
abstract: OBJECTIVE
  The current study evaluates long-term quality of life (QOL) and sexual function of patients with endometrial cancer who received adjuvant pelvic external beam radiotherapy (EBRT) and/or vaginal brachytherapy (BRT).
  
  
  METHODS
  One hundred forty-four endometrial cancer survivors who were treated between January 2000 and December 2009 in our department were included in this study. Median follow-up was 79 months (range, 31-138 months). Fifty-two patients were treated with 45 to 50.4 Gy EBRT, 76 were with BRT, and 16 were with both EBRT and BRT. Brachytherapy was in the form of vaginal cuff BRT with 5 × 550 cGy high dose rate BRT, prescribed to the first 4 cm and whole wall thickness of vagina. Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and subscales from the supplemental 24-item Cervical Cancer Module.
  
  
  RESULTS
  Vaginal BRT patients reported better physical functioning (P = 0.01), role functioning (P = 0.03), and sexual enjoyment (P = 0.01) compared to EBRT group. Symptom score (P = 0.01), lymphedema (P = 0.03), pain (P = 0.02), and diarrhea (P = 0.009) scores were also higher with EBRT. Vaginal BRT did not worsen symptom scores or sexual functions when added to EBRT. Obese patients experienced higher rates of lymphedema (P = 0.008). Cognitive and role functioning scores were significantly higher in patients with normal body mass index.
  
  
  CONCLUSIONS
  External beam radiotherapy negatively affects long-term QOL and sexual functions in endometrial cancer survivors. Vaginal BRT provides higher QOL. Patients with body mass index within normal limits have improved QOL.
authors.affiliation: *Department of Radiation Oncology, Ankara Ataturk Training and Research Hospital; †Department of Radiation Oncology, Hacettepe University, Faculty of Medicine; ‡Department of Gynecological Oncology, Etlik Zubeyde Hanim Training and Research Hospital; §Department of Gynecological Oncology, Hacettepe University, Faculty of Medicine; ∥Department of Gynecological Oncology, Baskent University Faculty of Medicine; and ¶Department of Preventive Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
authors.forename: Havva
authors.initials: H
authors.lastname: Karabuga
authors.forename: Melis
authors.initials: M
authors.lastname: Gultekin
authors.forename: Gokhan
authors.initials: G
authors.lastname: Tulunay
authors.forename: Kunter
authors.initials: K
authors.lastname: Yuce
authors.forename: Ali
authors.initials: A
authors.lastname: Ayhan
authors.forename: Deniz
authors.initials: D
authors.lastname: Yuce
authors.forename: Ferah
authors.initials: F
authors.lastname: Yildiz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D016889:Endometrial Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010386:Pelvic Neoplasms / Q000523:psychology / Q000532:radiotherapy; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D017741:Survivors; D014625:Vaginal Neoplasms / Q000523:psychology / Q000532:radiotherapy