Sung Uk Lee, Young Ae Kim, Young-Ho Yoon, Yeon-Joo Kim, Myong Cheol Lim, Sang-Yoon Park, Sang-Soo Seo, Ji Eun Park, Joo-Young Kim
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of).
Cancer Policy Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of).
Strahlenther Onkol. 2017 Jul;193(7):543-551. doi: 10.1007/s00066-017-1143-8. Epub 2017 May 10.
To evaluate the global health status of long-term cervical cancer survivors (LCCS) who survived for more than 4 years after curative radiation treatment (RT).
Medical records of 562 women treated with RT in our institution between 2003 and 2010 were reviewed. Excluding 259 women who died of disease or were lost to follow-up, disease status and late morbidities were evaluated in 303 LCCS. Quality of life (QoL) was analyzed in 168 LCCS using a questionnaire from the European Organization for the Research and Treatment of Cancer, and the results were compared with an age-matched healthy Korean female population.
Median follow-up was 6.8 years (range 4.1-12.5 years). There were 14 deaths (7 cancer specific) and 14 recurrences (5 local recurrences and 9 distant metastases). The median time to recurrence was 6.0 years (range 4.1-8.2 years). Grade ≥2 late toxicities were frequently observed in the bladder (19%) and small/large intestine (15%). Multivariate analysis revealed a higher rate of late toxicity in patients aged ≥51 years at diagnosis (small/large intestine: hazard ratio, HR, 2.5 [1.2-5.5]; bladder: HR 2.4 [1.3-4.5]; and bone: HR 4.3 [1.2-15.8]) than patients aged <51 years. Compared to the general population, LCCS exhibited a significantly higher rate of body image concerns, sexual dysfunction, lymphedema, and peripheral neuropathy.
New recurrences occurred in 5% of LCCS and grade ≥2 treatment-related morbidities were present in 33%. A significant proportion of LCCS also showed decreased cervical-cancer-specific QoL. These results suggest the need for long-term surveillance and follow-up care for LCCS.
评估在接受根治性放射治疗（RT）后存活超过4年的长期宫颈癌幸存者（LCCS）的整体健康状况。
回顾了2003年至2010年间在本机构接受RT治疗的562名女性的病历。排除259名死于疾病或失访的女性，对303名LCCS评估疾病状态和晚期并发症。使用欧洲癌症研究与治疗组织的问卷对168名LCCS的生活质量（QoL）进行分析，并将结果与年龄匹配的健康韩国女性人群进行比较。
中位随访时间为6.8年（范围4.1 - 12.5年）。有14例死亡（7例与癌症相关）和14例复发（5例局部复发和9例远处转移）。复发的中位时间为6.0年（范围4.1 - 8.2年）。膀胱（19%）和小肠/大肠（15%）中经常观察到≥2级的晚期毒性。多变量分析显示，诊断时年龄≥51岁的患者比年龄<51岁的患者出现晚期毒性的发生率更高（小肠/大肠：风险比，HR，2.5 [1.2 - 5.5]；膀胱：HR 2.4 [1.3 - 4.5]；骨骼：HR 4.3 [1.2 - 15.8]）。与一般人群相比，LCCS出现身体形象问题、性功能障碍、淋巴水肿和周围神经病变的发生率显著更高。
5%的LCCS出现新的复发，33%存在≥2级与治疗相关的并发症。相当一部分LCCS还表现出宫颈癌特异性QoL下降。这些结果表明需要对LCCS进行长期监测和后续护理。
