Department of Neurosurgery, Xi'an International Medical Center, Xi'an, Shaanxi Province, China.
Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
Gynecol Oncol. 2019 Sep;154(3):583-589. doi: 10.1016/j.ygyno.2019.07.005. Epub 2019 Jul 12.
To evaluate the health-related quality of life (HRQOL) in locally advanced cervical cancer (LACC) patients treated with neoadjuvant concurrent chemoradiation (CCRT) or radiation (RT) alone followed by radical surgery (RS).
In a single-center retrospective study from a prospective database, 275 FIGO Stage IB2-IIIB patients who underwent CCRT/RT + RS were included. HRQOL was prospectively assessed by EORTC QLQ-C30 and EORTC QLQ-CX24 prior to any treatment (baseline) and 6 months after surgery, respectively.
A statistically significant and clinically relevant improvement in physical functioning (P < 0.001) and role functioning (P = 0.002, P = 0.031) was observed in patients receiving either CCRT+RS or RT + RS at follow-up. In addition, quality of life (QoL), physical functioning, and social functioning were better in the RT + RS group than the CCRT+RS group after treatment (P = 0.028, P = 0.010, P = 0.014). Symptom scores of fatigue decreased in both groups over time (P < 0.001, P = 0.004) while insomnia decreased only in the RT + RS group (P = 0.042). Worsened menopausal symptoms were documented in both groups at follow-up (P = 0.001, P = 0.047), while lymphedema was deteriorated only in patients receiving CCRT + RS (P < 0.001). Sexuality scores did not differ between groups or over time with the exception of sexual worry, which was deteriorated in patients receiving RT + RS (P = 0.042).
QLQ-C30 functioning and tumor-related symptoms scores improved while lymphedema and menopausal symptoms worsened 6 months after neoadjuvant CCRT or RT alone followed by RS in LACC patients. Patients treated with RT + RS had a generally better HRQOL compared with those receiving CCRT+RS, though further validation with prospective randomized clinical trials is warranted.
评估新辅助同步放化疗（CCRT）或单纯放疗（RT）后行根治性手术（RS）治疗局部晚期宫颈癌（LACC）患者的健康相关生活质量（HRQOL）。
本研究为单中心回顾性研究，来源于前瞻性数据库，共纳入 275 例接受 CCRT/RT+RS 的 FIGO 分期 IB2-IIIB 期患者。在治疗前（基线）和术后 6 个月，分别采用 EORTC QLQ-C30 和 EORTC QLQ-CX24 对 HRQOL 进行前瞻性评估。
接受 CCRT+RS 或 RT+RS 治疗的患者在随访时，身体功能（P<0.001）和角色功能（P=0.002，P=0.031）有统计学意义且具有临床意义的改善。此外，治疗后 RT+RS 组的生活质量、身体功能和社会功能均优于 CCRT+RS 组（P=0.028，P=0.010，P=0.014）。两组患者的疲劳症状评分随时间推移而降低（P<0.001，P=0.004），而失眠症状仅在 RT+RS 组降低（P=0.042）。两组患者在随访时均出现更严重的绝经症状（P=0.001，P=0.047），而 CCRT+RS 组仅出现淋巴水肿恶化（P<0.001）。两组患者的性功能评分无差异，但 RT+RS 组的性担忧恶化（P=0.042）。
新辅助 CCRT 或 RT 后行 RS 治疗 LACC 患者，6 个月后，QLQ-C30 功能和肿瘤相关症状评分改善，而淋巴水肿和绝经症状恶化。与接受 CCRT+RS 治疗的患者相比，接受 RT+RS 治疗的患者一般具有更好的 HRQOL，但需要前瞻性随机临床试验进一步验证。
