Nakamura Keiichiro, Masuyama Hisashi, Ida Naoyuki, Haruma Tomoko, Kusumoto Tomoyuki, Seki Noriko, Hiramatsu Yuji
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Int J Gynecol Cancer. 2017 Jan;27(1):117-122. doi: 10.1097/IGC.0000000000000840.
Cervical cancer is one of the most common malignant diseases in working-age women. This study investigated the influence of adverse effects of various treatment modalities on return to work in women with cervical cancer.
Questionnaires and clinical data from medical records of 97 patients with early stage (stages I and II) cervical cancer were collected and assessed by treatment received. The following treatment groups were analyzed for correlations between time to return to work and various adverse effects: radical hysterectomy (RH) alone, RH group (n = 29); concurrent chemoradiation therapy (CCRT)/radiation therapy (RT) alone, CCRT/RT group (n = 21); and RH + CCRT/RT group (n = 47). The χ test was used to determine the significance of the correlations.
The mean age at the time of diagnosis was 43.0 years and the average interval since treatment was 4.5 years. The RH + CCRT/RT group was the most strongly negatively associated with return to work in employed patients who had undergone CCRT/RT group of cervical cancer (P = 0.012). There was a significant association between failure to return to work and lower extremity lymphedema (P = 0.049). A more than-6-month interval between treatment and return to work and reduced personal income occurred in a significantly higher percentage of patients in the RH + CCRT group than in the CCRT/RT group (P = 0.034 and P = 0.034).
Of the treatments assessed, RH + CCRT/RT has the greatest negative effect on return to work in women with cervical cancer.
宫颈癌是育龄期女性最常见的恶性疾病之一。本研究调查了各种治疗方式的不良反应对宫颈癌患者恢复工作的影响。
收集97例早期（I期和II期）宫颈癌患者的问卷及病历临床资料，并根据接受的治疗进行评估。分析以下治疗组恢复工作时间与各种不良反应之间的相关性：单纯根治性子宫切除术（RH），RH组（n = 29）；同步放化疗（CCRT）/单纯放疗（RT），CCRT/RT组（n = 21）；以及RH + CCRT/RT组（n = 47）。采用χ检验确定相关性的显著性。
诊断时的平均年龄为43.0岁，治疗后的平均间隔时间为4.5年。在接受过CCRT/RT的在职宫颈癌患者中，RH + CCRT/RT组与恢复工作的负相关性最强（P = 0.012）。未能恢复工作与下肢淋巴水肿之间存在显著关联（P = 0.049）。与CCRT/RT组相比，RH + CCRT组中治疗至恢复工作间隔超过6个月以及个人收入减少的患者比例显著更高（P = 0.034和P = 0.034）。
在所评估的治疗方式中，RH + CCRT/RT对宫颈癌患者恢复工作的负面影响最大。
