Sorokin Pavel, Kulikova Svetlana, Nikiforchin Andrei, Ulrikh Elena
Gynecologic Oncology, Moscow City Oncology Hospital No. 62, Istra, RUS.
Gynecologic Oncology, Almazov National Medical Research Center, Saint Petersburg, RUS.
Cureus. 2024 Sep 4;16(9):e68642. doi: 10.7759/cureus.68642. eCollection 2024 Sep.
Introduction Given treatment advancements and the long life expectancy of mostly young patients with cervical cancer, their post-treatment quality of life (QoL) is essential to consider. This study aimed to evaluate the long-term QoL in cervical cancer survivors treated with various approaches. Methods We conducted a cross-sectional survey-based study using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Cervical Cancer Module 24 (EORTC-QLQ-CX24) questionnaires and involved members of the online cervical cancer patient support group (01/2024-02/2024). Eligible participants were ≥18 years old, diagnosed with stage IA2-IIB cervical cancer, and had completed their treatment. Respondents were stratified into four management groups: neoadjuvant chemotherapy + surgery +/- radiation therapy (RT), surgery + RT, RT alone, and surgery alone. Results Overall, 173 patients participated: 20 (11.6%) received neoadjuvant chemotherapy + surgery +/- RT, 50 (28.9%) had surgery + RT, 69 (39.9%) had RT alone, and 34 (19.7%) had surgery alone. Patients after surgery alone had significantly better global QoL (p<0.001). Their physical (p<0.001), role (p=0.037), emotional (p=0.024), and social (p=0.006) functioning were also substantially better. This group also reported the lowest severity of fatigue (p=0.001), nausea and vomiting (p<0.001), and diarrhea (p<0.001). Sexual functioning was better in the surgery-alone group in almost all aspects. There were no major differences in QoL among the groups, receiving RT alone or combined with other treatments. Conclusions Cervical cancer survivors who underwent surgery alone reported the highest QoL and lower symptom intensity compared to those treated with RT or treatment combinations. RT combined with other modalities did not appear to substantially decrease QoL compared to RT alone.
引言 鉴于治疗方法的进步以及大多数年轻宫颈癌患者较长的预期寿命，考虑她们治疗后的生活质量（QoL）至关重要。本研究旨在评估采用各种方法治疗的宫颈癌幸存者的长期生活质量。
方法 我们使用欧洲癌症研究与治疗组织生活质量问卷核心30（EORTC-QLQ-C30）和欧洲癌症研究与治疗组织宫颈癌模块24生活质量问卷（EORTC-QLQ-CX24）问卷，对在线宫颈癌患者支持小组的成员（2024年1月至2024年2月）进行了一项基于横断面调查的研究。符合条件的参与者年龄≥18岁，被诊断为IA2-IIB期宫颈癌，且已完成治疗。受访者被分为四个治疗组：新辅助化疗+手术+/-放疗（RT）、手术+放疗、单纯放疗和单纯手术。
结果 总体而言，173名患者参与：20名（11.6%）接受新辅助化疗+手术+/-放疗，50名（28.9%）接受手术+放疗，69名（39.9%）接受单纯放疗，34名（19.7%）接受单纯手术。单纯手术后的患者总体生活质量显著更好（p<0.001）。他们的身体（p<0.001）、角色（p=0.037）、情感（p=0.024）和社会（p=0.006）功能也明显更好。该组还报告疲劳（p=0.001）、恶心和呕吐（p<0.001）以及腹泻（p<0.001）的严重程度最低。几乎在所有方面，单纯手术组的性功能都更好。单纯接受放疗或与其他治疗联合的组之间生活质量没有重大差异。
结论 与接受放疗或联合治疗的患者相比，单纯接受手术的宫颈癌幸存者报告的生活质量最高，症状强度较低。与单纯放疗相比，放疗与其他方式联合似乎并没有显著降低生活质量。
