Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship: Results From the Randomized PORTEC-2 Trial
- Department of Radiation Oncology, Leiden University Medical Center, Leiden (Netherlands)
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands)
- Department of Radiotherapy, Medisch Spectrum Twente, Enschede (Netherlands)
- Arnhem Radiotherapy Institute (ARTI), Arnhem (Netherlands)
- Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)
- Radiotherapy Institute Friesland, Leeuwarden (Netherlands)
- Department of Radiation Oncology, Radiotherapy Group Deventer, Deventer (Netherlands)
- Research Department, Netherlands Comprehensive Cancer Organization, Eindhoven (Netherlands)
- Department of Medical Statistics, Leiden University Medical Center, Leiden (Netherlands)
- Comprehensive Cancer Center The Netherlands-West, Leiden (Netherlands)
- Department of Gynecologic Oncology, University Medical Center Groningen, Groningen (Netherlands)
Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC) survivors. Patients and Methods: In the PORTEC-2 trial, 427 patients with stage I high–intermediate-risk EC were randomly allocated to EBRT or VBT. The 7- and 10-year HRQL questionnaires consisted of EORTC QLQ-C30; subscales for bowel and bladder symptoms; the Impact of Cancer Questionnaire; and 14 questions on comorbidities, walking aids, and incontinence pads. Analysis was done using linear mixed models for subscales and (ordinal) logistic regression with random effects for single items. A two-sided P value <.01 was considered statistically significant. Results: Longitudinal HRQL analysis showed persisting higher rates of bowel symptoms with EBRT, without significant differences in global health or any of the functioning scales. At 7 years, clinically relevant fecal leakage was reported by 10.6% in the EBRT group, versus 1.8% for VBT (P=.03), diarrhea by 8.4% versus 0.9% (P=.04), limitations due to bowel symptoms by 10.5% versus 1.8% (P=.001), and bowel urgency by 23.3% versus 6.6% (P<.001). Urinary urgency was reported by 39.3% of EBRT patients, 25.5% for VBT, P=.05. No difference in sexual activity was seen between treatment arms. Long-term impact of cancer scores was higher among the patients who had an EC recurrence or second cancer. Conclusions: More than 7 years after treatment, EBRT patients reported more bowel symptoms with impact on daily activities, and a trend for more urinary symptoms, without impact on overall quality of life or difference in cancer survivorship issues.
- OSTI ID:
- 22645004
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 93, Issue 4; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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