title: Long-Term Toxicity and Quality of Life in Patients Treated for Locally Advanced Cervical Cancer.
abstract: OBJECTIVE
  The aim of this study was to analyze the long-term toxicity and quality of life (QOL) in patients with locally advanced cervical cancer (LACC) treated with chemoradiation [chemotherapy/radiotherapy (CT/RT)] or neoadjuvant CT (NACT) followed by radical surgery (RS).
  
  
  METHODS
  Fifty-nine patients with LACC in remission after treatment with NACT + RS (n = 34) or CT/RT (n = 25) were interviewed with an Incontinence Impact Questionnaire (IIQ-7), a Quality of Life Questionnaire (EORTC QLQ-C30), and a Quality of Life Questionnaire for Cervical Cancer (EORTC QLQ-CX24) to compare long-term toxicity and QOL.
  
  
  RESULTS
  The mean age was 53 ± 9.8 and 59 ± 11.5 years in the NACT + RS and CT/RT groups, respectively. Overall, diarrhea and constipation were reported in 15 and 68%, respectively, while bladder complaints and a low level of sexual enjoyment were reported in 36 and 47%, respectively. The NACT + RS patients showed a worse sexual activity (74.71 ± 33.57 vs. 92.06 ± 17.96; p = 0.019) and sexual enjoyment (71.21 ± 23.67 vs. 88.88 ± 21.71; p = 0.040) and more frequently complained of constipation (49.01 ± 34.06 vs. 26.66 ± 31.66; p = 0.013), while CT/RT patients more frequently suffered from diarrhea (1.96 ± 7.96 vs. 14.66 ± 28.40; p = 0.017).
  
  
  CONCLUSIONS
  Many patients treated for LACC have long-term complaints regarding sexual activity and bladder and bowel function. The majority of QOL aspects were similar in the two groups at long-term follow-up. However, diarrhea was more frequent and severe in CT/RT patients, while constipation was more frequent and severe in NACT + RS patients, and they showed a worse sexual life perception. Larger randomized trials addressing these issues are needed.
authors.affiliation: Department of Urology and Gynecology, Istituto Nazionale Tumori x2018;Fondazione G. Pascale', IRCCS, Naples, Italy.
authors.forename: Piera
authors.initials: P
authors.lastname: Gargiulo
authors.forename: Laura
authors.initials: L
authors.lastname: Arenare
authors.forename: Carmela
authors.initials: C
authors.lastname: Pisano
authors.forename: Sabrina Chiara
authors.initials: SC
authors.lastname: Cecere
authors.forename: Sara
authors.initials: S
authors.lastname: Falivene
authors.forename: Stefano
authors.initials: S
authors.lastname: Greggi
authors.forename: Rosa
authors.initials: R
authors.lastname: Tambaro
authors.forename: Gaetano
authors.initials: G
authors.lastname: Facchini
authors.forename: Giampaolo
authors.initials: G
authors.lastname: De Palma
authors.forename: Cono
authors.initials: C
authors.lastname: Scaffa
authors.forename: Chiara
authors.initials: C
authors.lastname: Della Pepa
authors.forename: Sandro
authors.initials: S
authors.lastname: Pignata
authors.forename: Marilena
authors.initials: M
authors.lastname: Di Napoli
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy; D059248:Chemoradiotherapy / Q000009:adverse effects*; D003248:Constipation / Q000209:etiology*; D003967:Diarrhea / Q000209:etiology*; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009367:Neoplasm Staging; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D011788:Quality of Life; D057566:Self Report; D012725:Sexual Behavior / Q000187:drug effects / Q000528:radiation effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*