BACKGROUND: The PORTEC-2 trial showed efficacy and reduced side-effects of vaginal brachytherapy (VBT) compared with external beam pelvic radiotherapy (EBRT) for patients with high-intermediate risk endometrial cancer. The current analysis was done to evaluate long-term health related quality of life (HRQL), and compare HRQL of patients to an age-matched norm population. METHODS: Patients were randomly allocated to EBRT (n=214) or VBT (n=213). HRQL was assessed using EORTC QLQ-C30 and subscales from PR25 and OV28 (bladder, bowel, sexual symptoms); and compared to norm data. FINDINGS: Median follow-up was 65 months; 348 (81%) patients were evaluable for HRQL (EBRT n=166, VBT n=182). At baseline, patient functioning was at lowest level, increasing during and after radiotherapy to reach a plateau after 12 months, within range of scores of the norm population. VBT patients reported better social functioning (p=0.005) and lower symptom scores for diarrhoea, faecal leakage, need to stay close to a toilet and limitation in daily activities due to bowel symptoms (p⩽0.001), compared to EBRT. There were no differences in sexual functioning or symptoms between the treatment groups; however, sexual functioning was lower and sexual symptoms more frequent in both treatment groups compared to the norm population. INTERPRETATION: Patients who received EBRT reported clinically relevant higher levels of bowel symptoms and related limitations in daily activities with lower social functioning, 5 years after treatment. VBT provides a better HRQL, which remained similar to that of an age-matched norm population, except for sexual symptoms which were more frequent in both treatment groups.
RCT Entities:
BACKGROUND: The PORTEC-2 trial showed efficacy and reduced side-effects of vaginal brachytherapy (VBT) compared with external beam pelvic radiotherapy (EBRT) for patients with high-intermediate risk endometrial cancer. The current analysis was done to evaluate long-term health related quality of life (HRQL), and compare HRQL of patients to an age-matched norm population. METHODS:Patients were randomly allocated to EBRT (n=214) or VBT (n=213). HRQL was assessed using EORTC QLQ-C30 and subscales from PR25 and OV28 (bladder, bowel, sexual symptoms); and compared to norm data. FINDINGS: Median follow-up was 65 months; 348 (81%) patients were evaluable for HRQL (EBRT n=166, VBT n=182). At baseline, patient functioning was at lowest level, increasing during and after radiotherapy to reach a plateau after 12 months, within range of scores of the norm population. VBT patients reported better social functioning (p=0.005) and lower symptom scores for diarrhoea, faecal leakage, need to stay close to a toilet and limitation in daily activities due to bowel symptoms (p⩽0.001), compared to EBRT. There were no differences in sexual functioning or symptoms between the treatment groups; however, sexual functioning was lower and sexual symptoms more frequent in both treatment groups compared to the norm population. INTERPRETATION:Patients who received EBRT reported clinically relevant higher levels of bowel symptoms and related limitations in daily activities with lower social functioning, 5 years after treatment. VBT provides a better HRQL, which remained similar to that of an age-matched norm population, except for sexual symptoms which were more frequent in both treatment groups.
Authors: Kimberly K Leslie; Kristina W Thiel; Michael J Goodheart; Koen De Geest; Yichen Jia; Shujie Yang Journal: Obstet Gynecol Clin North Am Date: 2012-06 Impact factor: 2.844
Authors: Christina Fotopoulou; Robert Kraetschell; Sean Dowdy; Keiichi Fujiwara; Nobuo Yaegashi; Domenica Larusso; Antonio Casado; Sven Mahner; Thomas J Herzog; Sean Kehoe; Ignace Vergote; David Scott Miller; Christian Marth; Shingo Fujii; Jalid Sehouli Journal: Arch Gynecol Obstet Date: 2014-10-15 Impact factor: 2.344
Authors: Therese Juul; Morten Aagaard Petersen; Bernhard Holzner; Søren Laurberg; Peter Christensen; Mogens Grønvold Journal: Qual Life Res Date: 2014-03-28 Impact factor: 4.147
Authors: Jeanne Carter; Helen Huang; Dana M Chase; Joan L Walker; David Cella; Lari Wenzel Journal: Int J Gynecol Cancer Date: 2012-11 Impact factor: 3.437
Authors: Shannon D Armbruster; Jaejoon Song; Andrea Bradford; Cindy L Carmack; Karen H Lu; Karen M Basen-Engquist Journal: Gynecol Oncol Date: 2016-09-24 Impact factor: 5.482