Frumovitz Michael, Sun Charlotte C, Schover Leslie R, Munsell Mark F, Jhingran Anuja, Wharton J Taylor, Eifel Patricia, Bevers Therese B, Levenback Charles F, Gershenson David M, Bodurka Diane C
Department of Gynecologic Oncology, 1155 Herman Pressler, CPB6.3244, Unit 1362, Houston, TX 77030, USA.
J Clin Oncol. 2005 Oct 20;23(30):7428-36. doi: 10.1200/JCO.2004.00.3996.
To compare quality of life and sexual functioning in cervical cancer survivors treated with either radical hysterectomy and lymph node dissection or radiotherapy.
Women were interviewed at least 5 years after initial treatment for cervical cancer. Eligible women had squamous cell tumors smaller than 6 cm at diagnosis, were currently disease-free, and had either undergone surgery or radiotherapy, but not both. The two treatment groups were then compared using univariate analysis and multivariate linear regression with a control group of age- and race-matched women with no history of cancer.
One hundred fourteen patients (37 surgery, 37 radiotherapy, 40 controls) were included for analysis. When compared with surgery patients and controls using univariate analysis, radiation patients had significantly poorer scores on standardized questionnaires measuring health-related quality of life (physical and mental health), psychosocial distress and sexual functioning. The disparity in sexual function remained significant in a multivariate analysis. Univariate and multivariate analyses did not show significant differences between radical hysterectomy patients and controls on any of the outcome measures.
Cervical cancer survivors treated with radiotherapy had worse sexual functioning than did those treated with radical hysterectomy and lymph node dissection. In contrast, these data suggest that cervical cancer survivors treated with surgery alone can expect overall quality of life and sexual function not unlike that of peers without a history of cancer.
比较接受根治性子宫切除术及淋巴结清扫术或放射治疗的宫颈癌幸存者的生活质量和性功能。
在宫颈癌初次治疗至少5年后对女性进行访谈。符合条件的女性在诊断时鳞状细胞瘤小于6 cm,目前无疾病,且接受了手术或放射治疗,但未同时接受两者。然后使用单因素分析和多变量线性回归将两个治疗组与无癌症病史的年龄和种族匹配的女性对照组进行比较。
114名患者(37名手术患者、37名放射治疗患者、40名对照)纳入分析。在使用单因素分析与手术患者和对照进行比较时,放射治疗患者在测量与健康相关的生活质量(身体和心理健康)、心理社会困扰和性功能的标准化问卷上得分显著更低。在多变量分析中,性功能差异仍然显著。单因素和多变量分析均未显示根治性子宫切除术患者与对照在任何结局指标上存在显著差异。
接受放射治疗的宫颈癌幸存者的性功能比接受根治性子宫切除术及淋巴结清扫术的患者更差。相比之下,这些数据表明,仅接受手术治疗的宫颈癌幸存者的总体生活质量和性功能与无癌症病史的同龄人无异。