Quality of life in patients treated by adjuvant radiotherapy for endometrial and cervical cancers: correlation with dose-volume parameters.

Abstract

Modern multidisciplinary cancer treatments aim at obtaining minimal influence on patients' quality of life (QoL). The purpose of this study was to assess QoL and correlate it with dose-volume parameters of organ at risks (OARs) in patients who received adjuvant radiotherapy for endometrial and cervical cancers. We administered the EORTC QLQ-C30 and EN24 or CX24 questionnaires to 124 patients, 100 with endometrial cancer and 24 with cervical cancer treated with postoperative radiotherapy±chemotherapy in regular follow-up. Bladder function, fecal incontinence or urgency and sexual functioning were investigated and correlated with dose-volume parameters of OAR by multiple linear regression analysis. This correlation was assessed by R (2) value. QoL was very high in the majority of patients (82.3% of patients). Few patients referred urinary incontinence (3.2%) or abdominal discomfort of high grade (4.0%). We found a significant correlation between bladder V40, i.e., absolute percentage of bladder volume that received a dose of 40Gy, and global health status (p<0.05, R (2)=0.17), urinary urgency (p<0.05, R (2)=0.24), urinary incontinence (p<0.05, R (2)=0.23) and dyspareunia (p<0.05, R (2)=0.04). We found also a correlation between global health status and mean dose to vagina (p<0.05, R (2)=0.17) and between maximum dose to lumbo-sacral plexus and abdominal pain (p<0.05, R (2)=0.07). Women treated with surgery and adjuvant radiotherapy for endometrial and cervical cancers have good QoL with minimal limitations of daily activities. QoL was correlated with dose-volume parameters such as bladder V40, mean dose to vagina, maximum dose to trigone and LSP.