title: Quality of life in patients treated by adjuvant radiotherapy for endometrial and cervical cancers: correlation with dose-volume parameters.
abstract: BACKGROUND
  Modern multidisciplinary cancer treatments aim at obtaining minimal influence on patients' quality of life (QoL). The purpose of this study was to assess QoL and correlate it with dose-volume parameters of organ at risks (OARs) in patients who received adjuvant radiotherapy for endometrial and cervical cancers.
  
  
  METHODS
  We administered the EORTC QLQ-C30 and EN24 or CX24 questionnaires to 124 patients, 100 with endometrial cancer and 24 with cervical cancer treated with postoperative radiotherapy ± chemotherapy in regular follow-up. Bladder function, fecal incontinence or urgency and sexual functioning were investigated and correlated with dose-volume parameters of OAR by multiple linear regression analysis. This correlation was assessed by R (2) value.
  
  
  RESULTS
  QoL was very high in the majority of patients (82.3 % of patients). Few patients referred urinary incontinence (3.2 %) or abdominal discomfort of high grade (4.0 %). We found a significant correlation between bladder V40, i.e., absolute percentage of bladder volume that received a dose of 40 Gy, and global health status (p < 0.05, R (2) = 0.17), urinary urgency (p < 0.05, R (2) = 0.24), urinary incontinence (p < 0.05, R (2) = 0.23) and dyspareunia (p < 0.05, R (2) = 0.04). We found also a correlation between global health status and mean dose to vagina (p < 0.05, R (2) = 0.17) and between maximum dose to lumbo-sacral plexus and abdominal pain (p < 0.05, R (2) = 0.07).
  
  
  CONCLUSIONS
  Women treated with surgery and adjuvant radiotherapy for endometrial and cervical cancers have good QoL with minimal limitations of daily activities. QoL was correlated with dose-volume parameters such as bladder V40, mean dose to vagina, maximum dose to trigone and LSP.
authors.affiliation: Department of Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy.|Chair of Radiotherapy, Department of Translational Medicine, University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pisani
authors.affiliation: Department of Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy.|Chair of Radiotherapy, Department of Translational Medicine, University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Deantonio
authors.affiliation: Chair of Radiotherapy, Department of Translational Medicine, University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.|Department of Obstetrics and Gynecology, University Hospital Maggiore della Carità, Novara, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Surico
authors.affiliation: Department of Medical Physics, University Hospital Maggiore della Carità, Novara, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Brambilla
authors.affiliation: Department of Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy.|Chair of Radiotherapy, Department of Translational Medicine, University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Galla
authors.affiliation: Department of Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy.|Chair of Radiotherapy, Department of Translational Medicine, University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Ferrara
authors.affiliation: Department of Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Masini
authors.affiliation: Department of Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gambaro
authors.affiliation: Chair of Radiotherapy, Department of Translational Medicine, University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.|Department of Obstetrics and Gynecology, University Hospital Maggiore della Carità, Novara, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Surico
authors.affiliation: Department of Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy. krengli@med.unipmn.it.|Chair of Radiotherapy, Department of Translational Medicine, University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy. krengli@med.unipmn.it.
authors.forename: M
authors.initials: M
authors.lastname: Krengli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects* / Q000379:methods; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*
keywords: Adjuvant radiotherapy; Cervical cancers; Dose–volume parameters; Endometrial cancer; Quality of life