Functional Assessment Of Cancer Therapy-Cervix Research Articles

QUALITY OF LIFE, ANXIETY AND DEPRESSION IN PATIENTS WITH ADVANCED CERVICAL CANCER

Objective: evaluate the quality of life (QOL), anxiety and depression scores of patients with cervical cancer treated with neoadjuvant chemotherapy followed by chemoradiotherapy. Methods: prospective cohort study of patients with advanced uterine cervix cancer treated with neoadjuvant chemotherapy followed by radiochemotherapy at a teaching hospital in northeastern Brazil between November 2013 and January 2017. Quality of life was evaluated at four time-points: pre-treatment, after neoadjuvant chemotherapy, after radiotherapy and three months after the end of treatment using Functional Assessment of Cancer Therapy-Cervix (FACT-Cx). Anxiety and depression, we used the Hospital scale of Anxiety and Depression. Results: We studied 40 women, aged 24 to 67 years with an average age of 48 ±11.4 years who had between zero and nine children (mean =3). Most were single (57.5%), illiterate and with elementary school education (85.0%). At the 1st and 4th evaluation, the mean anxiety scores were 7 ±3.5 and 5.5 ±3.6, respectively, and the mean depression scores were 4.4 ±3.2 and 3.7 ±2.6, respectively, with significant variation between the depression scores. The mean FACT-Cx scores at pretreatment were 112.3 ±17.4. At the last evaluation, the mean was 116.3 ±27.6 with a range from 52 to 155, with no significant difference. Conclusion: QOL scores remained stable throughout the treatment. There was a significant variation between the means and proportions of depression, possibly the result of the psychological support offered, demonstrating the importance of follow-up during oncologic treatment, mitigating the impacts of the disease and its treatment. There was no significant difference in anxiety.

Relationship between muscular fitness and quality of life as well as psychological distress in radiotherapy patients with cervical cancer.

Patients with cervical cancer who have received radiotherapy often suffer from systemic muscle volume reduction and quality of life decline due to systemic effects of tumor and side effects of radiotherapy. The purpose of this study was to investigate the status of muscle fitness, quality of life, and psychological pain in patients with cervical cancer who received radiotherapy, and to explore the correlation between muscle fitness, quality of life, and psychological pain. A total of 202 cervical cancer patients aged 19-71, who received radiotherapy in Hunan Cancer Hospital from July 2020 to February 2021, were selected by convenience sampling method. Functional Assessment of Cancer Therapy Cervix (FACT-CX) and Distress Thermometer (DT) were used for the survey. The patient's grip strength was assessed by a handgrip meter and compared with that of healthy Chinese women of the same age. The correlation between muscle fitness and quality of life and psychological pain was analyzed. The grip strength of cervical cancer patients receiving radiotherapy was significantly lower than that of healthy Chinese women at the same age (P<0.05). Multiple linear regression analysis showed that there were 4 factors affecting grip strength, including emotional thermometer score, social and family status score, cervical cancer related function score and tumor metastasis (all P<0.05). The grip strength of patients with cervical cancer undergoing radiotherapy is generally decreased, which is affected by many factors, and is closely related to the quality of life and psychological pain of patients. In the future, dynamic attention should be paid to the changes of grip strength and related functions in patients receiving radiotherapy for cervical cancer, the potential risks in the treatment should be identified early, and targeted intervention should be taken.

Healthy-related quality of life in patients with cervical cancer in Southwest China: a cross-sectional study

BackgroundCervical cancer is the second most common female malignant tumor in the world. According to a study in 2018, the incidence of cervical cancer in Yunnan Province of China was 11.42 per 100,000, the mortality rate was 3.77 per 100,000, and higher than the national average. Health-related quality of life (HRQoL) can be used not only in the selection and effect evaluation of clinical treatment plans of cervical cancer, but also in the evaluation of prognosis and long-term survival status. In this study, 288 cervical cancer patients admitted to the Yunnan Cancer Hospital in Southwest China from 2018 to 2020 were used as the survey objects to understand the HRQoL of cervical cancer patients and explore the related factors that affect HRQoL.MethodsThe Chinese version of the functional assessment of cancer therapy-cervix (functional assessment of cancer therapy-cervix v4.0, FACT-Cx V4) was used to investigate 288 patients with cervical cancer in Yunnan Province. Statistical analysis was performed using t-test, analysis of variance, multiple linear regression and other methods.ResultsThe total FACT-Cx score of cervical cancer patients was (130.16 ± 14.20), the physical well-being (PWB) score was (22.02 ± 4.47), the social/family well-being (SWB) score was (25.66 ± 3.59), the emotional well-being (EWB) score was (19.75 ± 3.54), the functional well-being (FWB) score was (16.91 ± 5.01) and the additional focus area (cervical cancer subscale, CxS) score was (45.78 ± 4.61). From the multi-factor analysis results, the scores of PWB, FWB, Cxs and the total FACT-Cx were related to the choice of different treatment methods, the PWB scores of patients with concurrent chemoradiotherapy was low(β = − 1.67, P = 0.003), the FWB scores of patients with concurrent chemoradiotherapy was low(β = − 2.02, P = 0.001), the CxS scores of patients with concurrent chemoradiotherapy was low(β = − 1.61, P = 0.006), the total score of FACT-Cx of patients with concurrent chemoradiotherapy was low(β = − 5.91, P = 0.001). SWB score was affected by marital status, married patients had high PWB scores(β = 5.44, P = 0.006). The patients with heavy disease expenditures as aproportion of family disposable income(β = − 3.82, P = 0.002) and aged 60 and above(β = − 3.29, P = 0.003) had lower FWB scores. The total score FACT-Cx of patients participating in cervical cancer screening was higher(β = 7.61, P = 0.001).ConclusionThe choice of treatment method is the common influencing factor of PWB, FWB, Cxs and the total FACT-Cx. Disease expenditures as a proportion of family disposable income, the treatment method, the marital status and whether to participate in cervical cancer screening affect the patient’s evaluation of their own HRQoL. Medical staff should pay special attention to the choice of different treatment methods, popularize vaccination knowledge and cervical cancer screening, give more humanistic care and health education to cervical cancer patients who have low education level, poor economic conditions, divorced or separated, and encourage patients to participate in active treatment to improve the health-related quality of life.

Comparison of neoadjuvant treatments followed by radical surgery or chemoradiation on quality of life in patients with stage IB2-IIA cervical cancer

ObjectiveTo compare quality of life (Qol) of patients with stage IB2-IIA cervical cancer treated by neoadjuvant treatments followed by radical surgery (NTS) or standard chemoradiation (CRT). MethodsPatients with stage IB2-IIA cervical cancer during 2006–2012 were treated with NTS or CRT and were invited to participate. The Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) Questionnaire was used to assess patient Qol. A multivariable linear regression analysis was performed to identify factors associated with Qol. ResultsIn total, 90 (78.3%) out of 115 eligible patients completed the questionnaires. No significant differences were found in Qol between treatment groups, except that patients after NTS reported higher scores in the social/family well-being (e.g. satisfaction with sexual life, close relationships with partner or friends, and support from friends) than those after CRT, in particular, during 2–3 years after treatment. Results of multivariate analysis indicated that NTS was associated with better social/family functioning, while advanced stage of cervical cancer, lower family income and lower education were associated with impaired Qol in different domains. ConclusionsAlthough self-reported Qol after treatment were not significantly different, NTS treated patients reported better social/family functioning than CRT treated patients, such as satisfaction with their sexual life and close relationships with partner or friends, during 2–3 years post treatment. These results were helpful for physicians to make treatment decisions while considering treatment-related Qol, and moreover, for rehabilitation and supportive care of patients after treatment. Further validation of our findings in randomized, controlled clinical trials is warranted.

Identificação de Conceitos da Classificação Internacional de Funcionalidade, Incapacidade e Saúde em Medidas de Qualidade de Vida para o Câncer do Colo do Útero

Introdução: o câncer do colo do útero apresenta elevada incidência em países de baixa e média rendas e provoca repercussões negativas sobre a funcionalidade das mulheres. o interesse na mensuração de medidas terapêuticas, que não se restrinjam às medidas do modelo biomédico, vem assumindo destaque no campo da oncologia. a classificação internacional de Funcionalidade (ciF) aparece no cenário mundial como ferramenta de orientação para construção da avaliação biopsicossocial. Objetivo: exemplificar a metodologia para identificação dos componentes da funcionalidade em escalas específicas utilizadas no cuidado oncológico para mulheres com câncer do colo do útero. Método: estudo realizado em três etapas: análise de revisões sistemáticas para identificação dos instrumentos específicos para avaliação de câncer do colo do útero; extração das medidas de avaliação; e ligação dos conceitos contidos nas medidas de desfecho com as categorias correspondentes da ciF por dois revisores independentes. Resultados: na análise do Functional Assessment of Cancer Therapy-Cervix e do European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Cervical Cancer Module, identificaram-se 72 conteúdos principais ligados a 35 categorias da ciF. destas, 23 referiam-se às funções corporais, oito às atividades e participação, três aos fatores ambientais e uma à estrutura corporal. Conclusão: os dois instrumentos possuem ligação com a ciF, no entanto, exploram de forma insuficiente os fatores contextuais, o que demonstra a necessidade de orientação biopsicossocial nas avaliações em saúde para mulheres com câncer do colo do útero de maneira a contemplar, de forma equânime, os componentes da funcionalidade na aferição dos desfechos terapêuticos.

Effects of health education based on the theory of planned behavior on the quality of life and sexual life in patients with cervical cancer

Objective To explore the effects of the health education model based on the theory of planned behavior (TPB) on the quality of life and sexual life in patients with cervical cancer six months after the surgery. Methods Totally 60 patients with cervical cancer who were treated and received surgery in the First Maternity and Infant Hospital Affiliated to Tongji University from March 2016 to April 2017 were selected by convenient sampling, and equally divided into a control group and a treatment group according to the random number table. Patients in the control group received routine health education after the surgery, while patients in the treatment group received the health education based on TPB. The Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) and the Female Sexual Function Index (FSFI) were used to observe the difference in the quality of life and sexual life between the patients in the two groups six months after the surgery. Results The total scores in all dimensions of FACT-Cx of the patients in the treatment group six months after the surgery was higher than that of the patients in the control group (P<0.05) . In FSFI, the scores in dyspareunia and sexual satisfaction of the patients in the treatment group were higher than those of the patients in the control group (P<0.05) . Conclusions The health education model based on TPB can effectively improve the quality of life and sexual life in patients with cervical cancer six months after the surgery, thus worthy of clinical application. Key words: Quality of life; Cervical cancer; Quality of sexual life; Theory of planned behavior

A Prospective Survey on Quality of Life Among Chinese Cervical Cancer Survivors at Different Time Stages after Radiation Therapy

Radiotherapy (RT) for cervical cancer carries a risk of gastrointestinal (GI) and genitourinary toxicity, which might adversely affect the quality of life (QoL). There is a paucity of data on treatment factors for long-term QoL. The purpose of this study was to assess the QoL of cervical cancer survivors in the different time periods within 3 years after RT. A prospective study was conducted among 1610 cervical cancer patients who received radical RT or postoperative RT with or without concurrent chemotherapy in 2010-2013 at the Zhejiang Cancer Hospital in China. The survey started from Jan 2013 to the end of Dec 2014. A total of 1876 valid questionnaires were received, 266 patients received twice surveys at different time points. The QoL was evaluated by the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) and a four-item radiotherapy complication self-made scale consisted of brief four Yes–No questions in the side effects of GI and genitourinary. The QoL have been assessed and compared in seven different time stages (1, 2-6, 7-12, 13-18,19- 24, 25-30, 31-36 months) after RT. Data for tumor characteristics at diagnosis, treatment and disease progression were available. Multivariate analysis and logistic regression were performed to identify factors associated with QoL. Our findings indicated that the QoL scores of patients with cervical cancer was gradually improved over time after RT. Multivariate analysis showed that the women with these factors: the shorter time after RT, diarrhea, constipation, lower urinary tract dysfunction, lower extremity lymphedema, marital status (Single or divorced), the lower family income , asexual life and without health insurance had significantly worse QoL (P<0.05). The multivariate analysis of different stages showed that intestinal dysfunction, lower urinary tract dysfunction, marital status and sexual life were independent factors those have affected the QoL at least three time periods. The overall trend of QoL of cervical cancer survivors was gradually improved over time after RT. Late gastrointestinal and genitourinary toxicity after RT had significant negative impact on the QoL of patients, So more attention should be focused on how to prevent and treat the long-term toxicities of RT.

Effect of five notes music therapy in traditional Chinese medicine on life quality of patients with cervical cancer during chemotherapy

Objective To explore the effect of five notes music therapy in traditional Chinese medicine (TCM) on life quality of patients with cervical cancer during chemotherapy. Methods A total of 84 patients with cervical cancer were randomly divided into experimental group (n=41) and control group (n=43) . The conventional chemotherapy was performed in both groups. Additionally, the five notes music therapy was performed in experimental group, and patients in control group listened to the general music. After 3 weeks, the functional assessment of cancer therapy-cervix (FACT-Cx) and self-rating anxiety scale (SAS) were used to evaluate the patients′ quality of life and anxiety in two groups. Results After intervention, the score of FACT-Cx in experimental group and control group was (143.68±2.36) and (127.20±3.09) , respectively. The difference between two groups was statistically significant (t=23.870, P<0.05) . The score of SAS in experimental group and control group was (40.37±0.81) and (48.17±0.15) , respectively. The difference between two groups was statistically significant (t=-24.086, P<0.05) . Conclusions Five notes music therapy can improve the quality of life in patients with cervical cancer during chemotherapy. Key words: Cervical cancer; Quality of life; Chemotherapy; Five notes music therapy

Quality of life after radical trachelectomy for early-stage cervical cancer: A 5-year prospective evaluation

ObjectivesTo longitudinally assess quality of life (QOL) in women undergoing radical trachelectomy for early-stage cervical cancer. MethodsWe prospectively enrolled patients with stage IA1-IB1 cervical cancer prior to undergoing radical trachelectomy to complete validated QOL instruments. These instruments included the General Health-Related QOL (SF-12), Functional Assessment of Cancer Therapy-Cervix (FACT-Cx), MD Anderson Symptom Inventory (MDASI), Female Sexual Functioning Index (FSFI), and Satisfaction with Decision scale (SWD). Instruments were filled out at baseline, postoperatively at 6weeks, 6months, 1year, and annually thereafter for 4years. ResultsThirty-nine patients enrolled in the study, and 32 patients were evaluable. The scores for FSFI-arousal (p=0.0002), lubrication (p<0.0001), orgasm (p=0.006), pain (p=0.01), satisfaction (p=0.03) and total score (p=0.004) showed a significant decline at 6weeks then returned to baseline levels by 6 months. The scores for FACT-Cx functional well-being (p=0.02) and physical well-being (p<0.0001), SF-12 bodily pain (p<0.0001), physical functioning (p<0.0001), role physical (p<0.0001), role emotional (p=0.03), social functioning (p=0.002), and MDASI total (p=0.04) showed significantly worsened symptoms at 6weeks then returned to baseline by 6months. The scores for FACT-Cx emotional well-being showed significant worsening of symptoms that persisted at 6-weeks (p=0.004), 6months (p=0.007), 1year (p=0.001), 2years (p=0.002), and 4 years (p=0.03). There was no difference in SWD. ConclusionsSeveral quality of life assessments decline immediately postoperatively after radical trachelectomy, however, return to baseline thereafter. The long-term emotional impact of this surgery highlights a need for perioperative counseling in these patients.

Prospective evaluation of quality of life and sexual functioning after radical trachelectomy for early-stage cervical cancer

Objectives: To longitudinally assess quality of life (QOL), sexual functioning, and satisfaction with healthcare decisions in women who have undergone radical trachelectomy for early-stage cervical cancer.Methods: After institutional review board approval, we prospectively enrolled patients with stage IA1-IB1 cervical cancer before undergoing radical trachelectomy to complete validated instruments to assess QOL. These instruments included the General Health-Related QOL (SF-12), the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx), the MD Anderson Symptom Inventory (MDASI), Female Sexual Functioning Index (FSFI), and Satisfaction with Decision (SWD) scale. Instruments were filled out preoperatively (baseline), 4 to 6 weeks postoperatively, at 6 months, at 1 year, and annually thereafter for 4 years. Mixed modeling was used to test for changes from baseline for the survey instruments. A subanalysis was performed comparing QOL scores based on surgical approach.xResults: Thirty-nine patients enrolled in the study, and 35 patients were evaluable. Four patients were excluded because of conversion to radical hysterectomy or limited study participation time. Median age was 30.8 years (range, 21.4–38.7). Median body mass index was 25 kg/m2 (range, 16.1–44.4). Most patients had stage IB1 disease (51%) and underwent robotic radical trachelectomy (69%). The FSFI-arousal (P = .0001), FSFI-lubrication (P < .0001), FSFI-orgasm (P = .0012), FSFI-satisfaction (P = .02), and FSFI-total (P = .002) showed a significant decline at the 4- to 6-week postoperative visit then returned to baseline levels by 6 months. Similarly, the FACT-Cx physical well-being (P < .0001), FACT-Cx social well-being (P < .0001), SF-12 bodily pain (P < .0001), SF-12 physical functioning (P < .0001), SF-12 physical role (P < 0.0001), and SF-12 social functioning (P = .0002) showed a significant decline at the 4-to 6-week postoperative visit then returned to baseline by 6 months. There were no differences in the MDASI or SWD over the follow-up period. There were no differences in QOL scores based on an open versus minimally invasive surgical approach.Conclusions: Several QOL, sexual, and functional assessments decline immediately postoperatively after radical trachelectomy. However, they return to baseline measures by 6 months postoperatively, affording these patients long-term satisfaction with their procedural outcomes regardless of surgical approach. Objectives: To longitudinally assess quality of life (QOL), sexual functioning, and satisfaction with healthcare decisions in women who have undergone radical trachelectomy for early-stage cervical cancer. Methods: After institutional review board approval, we prospectively enrolled patients with stage IA1-IB1 cervical cancer before undergoing radical trachelectomy to complete validated instruments to assess QOL. These instruments included the General Health-Related QOL (SF-12), the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx), the MD Anderson Symptom Inventory (MDASI), Female Sexual Functioning Index (FSFI), and Satisfaction with Decision (SWD) scale. Instruments were filled out preoperatively (baseline), 4 to 6 weeks postoperatively, at 6 months, at 1 year, and annually thereafter for 4 years. Mixed modeling was used to test for changes from baseline for the survey instruments. A subanalysis was performed comparing QOL scores based on surgical approach. xResults: Thirty-nine patients enrolled in the study, and 35 patients were evaluable. Four patients were excluded because of conversion to radical hysterectomy or limited study participation time. Median age was 30.8 years (range, 21.4–38.7). Median body mass index was 25 kg/m2 (range, 16.1–44.4). Most patients had stage IB1 disease (51%) and underwent robotic radical trachelectomy (69%). The FSFI-arousal (P = .0001), FSFI-lubrication (P < .0001), FSFI-orgasm (P = .0012), FSFI-satisfaction (P = .02), and FSFI-total (P = .002) showed a significant decline at the 4- to 6-week postoperative visit then returned to baseline levels by 6 months. Similarly, the FACT-Cx physical well-being (P < .0001), FACT-Cx social well-being (P < .0001), SF-12 bodily pain (P < .0001), SF-12 physical functioning (P < .0001), SF-12 physical role (P < 0.0001), and SF-12 social functioning (P = .0002) showed a significant decline at the 4-to 6-week postoperative visit then returned to baseline by 6 months. There were no differences in the MDASI or SWD over the follow-up period. There were no differences in QOL scores based on an open versus minimally invasive surgical approach. Conclusions: Several QOL, sexual, and functional assessments decline immediately postoperatively after radical trachelectomy. However, they return to baseline measures by 6 months postoperatively, affording these patients long-term satisfaction with their procedural outcomes regardless of surgical approach.

Survey of cervical cancer survivors regarding quality of life and sexual function.

To investigate the quality of life (QOL) of cervical cancer survivors in China. Cervical cancer survivors were selected from 4 Tertiary Provincial Hospitals in Changsha, Hunan Province. Enrolled were 140 patients who received cancer treatments in these hospitals from 2007 to 2010. The Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) Questionnaire was used to assess the QOL of the participants. Spiritual well-being was evaluated with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp). Sexual function was measured with the Female Sexual Functioning Index. The average total FACT-Cx score was 124.45 (70-157). The average FACT-general score was 112.39 (49-150), and the average FACIT-Sp score was 13.9 (2-33.6). The prevalence of sexual dysfunction in our participants was 78%. Factors that were associated with QOL in cervical cancer survivors included gastrointestinal symptoms, health insurance, age, sleep disorders, and the number of complications. Sexual function was affected by radiotherapy, age, type of surgery, sleep disorders, and occupation. The QOL and sexual function of cervical cancer survivors were lower than the general population. Treatment-related complications and sexual dysfunction significantly affected patients' QOL. Having health insurance was associated with better QOL. Sexual function was adversely affected by radiotherapy and radical hysterectomy.

Factors associated with grade 3 or 4 treatment-related toxicity in women with advanced or recurrent cervical cancer: an exploratory analysis of NRG Oncology/Gynecologic Oncology Group trials 179 and 204.

This study aimed to describe pretreatment patient characteristics and baseline quality-of-life scores as they relate to the development of grade 3 or 4 toxicity in patients receiving chemotherapy for advanced/recurrent cervical cancer. The study sample was drawn from Gynecologic Oncology Group protocols 179 and 204. Grade 3 or 4 toxicities were considered in 4 specified categories as follows: peripheral neuropathy, fatigue, hematological, and gastrointestinal (GI). The data variables explored included age, stage, pretreatment radiation, performance status (PS) at treatment initiation, and baseline Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) score. A logistic regression model was developed with various adverse events as binary (0/1) outcomes. Six hundred seventy-three patient-reported questionnaires were used in the analyses. At baseline, pain was the most severe patient-reported symptom. Baseline line-item patient concerns did demonstrate specific correlations with the development of individual toxicities. In 401 patients who were enrolled on Gynecologic Oncology Group 204 (fatigue not measured on 179), a worse PS predicted the development of grade 3 or 4 fatigue (odds ratio, 2.78; 95% confidence interval, 1.66-4.68). Exposure to previous radiation, treatment regimen, and a worse FACT-Cx score were associated with the reporting of both grade 3 or 4 leukopenia (P < 0.05) and anemia (P < 0.0005). Performance status and treatment regimen (P < 0.05) were associated with the development of grade 3 or 4 thrombocytopenia. Age and treatment regimen (P < 0.05) were associated with the development of grade 3 or 4 neutropenia. The FACT-Cx score (P = 0.0016) predicted grade 3 or 4 GI toxicity. The development of fatigue, hematological, and GI toxicity might be predictable based on factors other than treatment assignment such as age, PS, and patient-reported quality-of-life measurement.

Evaluation of the Psychometric Properties of the Functional Assessment of Cancer Therapy-Cervix Questionnaire in Brazil

BackgroundAlthough cervical cancer is ​​the second most common tumor among Brazilian women, studies that evaluate the quality of life of these women are still scarce. This situation is explained by the lack of specific and validated tools for this purpose in Portuguese (Brazil). The aim of this study was to evaluate the psychometric properties of the Portuguese version of the FACT-CX (Functional Assessment of Cancer Therapy-Cervix) questionnaire in a population of Brazilian women with cervical cancer.MethodsThe psychometric properties of the FACT-CX questionnaire were tested in a sample of 100 women diagnosed with cervical cancer who were previously treated in the Barretos Cancer Hospital. We analyzed the internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient - ICC), confirmatory factor analysis, convergent validity (correlation with the SF-36 questionnaire), and discriminant validity by disease stage and two questions related to self-perception of health was also performed.ResultsThe scales had Cronbach´s alpha coefficients ranging from 0.61 to 0.80. However, three scales did not have a statistically significant coefficient greater than 0.70. The ICC ranged from 0.68 to 0.82 and all considered satisfactory. Factor analysis did not generate consistent components. The FACT-G and FACT-CX total scores had good internal consistency and reproducibility, and also correlated well with the General Health and Vitality scales of the SF-36. However, only two FACT-CX scales had a significant correlation with SF-36. Discriminant analysis showed that FACT-CX failed to discriminate groups according to clinical stage but was able to divide the women according to the self-perception of health.ConclusionFATC-CX total score had good internal consistency, reproducibility and discriminant validity. In addition, it correlated well with General Health and Vitality scales of SF-36. However, three scales had questionable internal consistency and only two had significant correlation with SF-36.

Health-Related Quality of Life and Associated Factors in Chinese Women With Cervical Cancer

There is a lack of health-related quality of life (HRQOL) studies in Chinese women with cervical cancer. The objectives of this study were to investigate the HRQOL trajectory in women with cervical cancer in Mainland China in the 9 months following diagnosis and to identify factors that influence HRQOL. Initially, 187 patients with cervical cancer were included in the study, but at each follow-up, the number declined to 128, 112, and 106, respectively. The Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) was used to collect data sequentially at the time of diagnosis (T1) and at 3 (T2), 6 (T3), and 9 months after diagnosis (T4). Medical characteristics, sense of coherence, and social support were included as factors likely to contribute to HRQOL. Functional Assessment of Cancer Therapy-Cervix ranged in mean from 120.30 at T1 to 126.22 at T4 (P = .001), whereas social/family well-being ranged from 23.56 at T1 to 20.23 at T4 (P = .025). In the stepwise regression with FACT-Cx as the independent variable, sense of coherence entered the equation with the highest standardized coefficients (0.554) at T1 and stage II at T2 and T3 (-0.53 and -0.26, respectively). Satisfaction with family relationships had the second highest standardized coefficient (-0.21) at T3. Overall HRQOL improved, although social/family well-being deteriorated. Sense of coherence contributed to HRQOL initially, whereas disease stage and family support did so later on. The study highlights the importance of identifying those with a low sense of coherence at the time of diagnosis. Family members should be included in caring process as a vital source of social support.

1429P - Assessment of Quality of Life of Patients with Cervical Cancer During and After Treatment with Radiotherapy in Instituto De Medicina Integral Professor Fernando Figueira, Recife, Brazil

ABSTRACT Introduction Cervical cancer is the 2nd most frequent neoplasm among women in Brazil. Radiotherapy is one of the modalities used in the treatment of cervical cancer and may cause adverse events that compromise quality of life. The purpose of this study was assess quality of life in women with cervical cancer before, during the last week and six months after radiotherapy at a hospital in Northeast, Brazil. Method We performed an exploratory, before and after longitudinal study, with 35 women with cervical cancer treated with adjuvant radiotherapy, exclusively or concurrently with chemotherapy in Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) between August 2012 and May 2012. The patients underwent three interviews (pre-treatment, last week and six months after treatment). To assess the quality of life it was used FACT-Cx score (Functional Assessment of Cancer Therapy-Cervix). The mean scores were compared using Student's t and ANOVA test, with significance level of 5%. Results The mean age was 50 (± 13.9) years. Most were single or widowed (58.8%) and only 2.9% were employed. About 75% attended just until elementary school. The FACT-Cx pre-treatment average scores was 110.9 and in the last week was 110.8, with no statistically significant difference (p = 0.966). The results corresponding to six months after therapy will be presented at the Meeting. Conclusion The immediate results after radiotherapy showed no difference in quality of life. Analysis after six months may be different. These findings may modify therapeutic decision. Disclosure All authors have declared no conflicts of interest.

Psychometric properties of the Chinese version of the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) measuring health-related quality of life

BackgroundThe Functional Assessment of Cancer Therapy (FACT) is one of the most commonly used self-report instruments for evaluation of health-related quality of life in oncology patients. However, cultural considerations necessitate testing of the subscales in different populations. We sought to qualitatively and quantitatively investigate the applicability and psychometric properties of the Chinese version of the FACT-Cervix (FACT-Cx) in Chinese women with cervical cancer.MethodsTen personal interviews were conducted in order to explore patients’ opinions about the scale and its items in depth. In addition the questionnaire was administered to 400 women with cervical cancer to test its psychometric properties. Reliability was assessed using Cronbach’s alpha coefficient and item-subscale correlation while validity was evaluated using factor analysis and known-group validity.ResultsSome items related to sex and the ability to give birth were questioned in the personal interviews, mostly regarding their significance and acceptance in the Chinese cultural context. The Cronbach’s alphas of FACT-Cx and the subscales were greater than 0.7, except for the cervical-cancer-specific subscale which was 0.57. Factor analysis demonstrated that the FACT-G construct generally paralleled the original. There were significant differences in the FACT-Cx and some subscales between those receiving and not receiving treatment and among the patients with different performance status.ConclusionsIn general, psychometric properties of the Chinese version supported its use with cervical cancer patients in Mainland China. Further work is needed to improve the psychometric adequacy of the cervical-cancer-specific subscale and adjust it to cultural considerations.

Psychometric properties of the Chinese version of Sense of Coherence Scale in women with cervical cancer

The purpose of this study was to test the psychometric properties of a Chinese version of the Sense of Coherence Scale (C-SOC-13) in women with cervical cancer in Mainland China. The C-SOC-13 and Health-related Quality of Life scale (Functional Assessment of Cancer Therapy-Cervix) were administered to 238 women with cervical cancer. Validity was assessed in terms of factor validity, predictive validity, divergent validity and stability, whereas reliability was evaluated using Cronbach's alpha coefficient. This study showed that in confirmatory factor analysis, the first-order interrelated three-factor model and second-order model were performed based on Antonovsky's theoretical structure of Sense of Coherence (SOC). Both models fitted the data satisfactorily when the largest modification index was released. The chi-square value/degrees of freedom was 2.120, the goodness-of-fit index was 0.919, the root mean square error of approximation was 0.069, and the comparative fit index was 0.911. The Pearson correlation coefficient between SOC and Functional Assessment of Cancer Therapy-Cervix was 0.611. Enter multiple regression with SOC as a dependent variable and medical and socio-economic variables as independent variables showed no statistically significant partial coefficient of any independent variable in regression equation except for age. The Cronbach's alpha coefficient for the scale was 0.824. The factor validity, predictive validity and divergent validity of C-SOC-13 were reasonable, as well as the internal consistency. In general, C-SOC-13 showed to be suitable as an SOC measurement for women with cervical cancer in Mainland China. However, SOC may have a different meaning to Chinese people because of the philosophy and culture that shape the context of their lives. Generalizing the findings to other populations requires further psychometric evaluation of C-SOC-13. Further longitudinal studies are also needed to explore the stability.

Validación de la escala FACT-Cx en Colombia usando el modelo de teoría de respuesta al ítem

ObjectiveTo determine the psychometric properties and measurement features of the Functional Assessment of Cancer Therapy-Cervix (FACTCx) by means of Rasch analysis. MethodsA scale validation study using the FACT-Cx questionnaire was carried out among 218 cervical cancer patients. Following item scoring, analysis was performed with the partial credit Rasch model for polytomous data. ResultsThe highest score corresponded to the domain of 'specific concerns related to cervical pathology'. Items showed adequate reliability and separation rates (0.89 and 5.96, respectively). In the cases of individual persons, the lower index values suggest a restricted construct range in this sample. Adjustment indicators suggest construct homogeneity. Family support scored highest as having positive impact on quality of life; whereas, a sense of hopelessness rated as the most negative. The item related to concern over reproductive ability was not adequately measured by the construct; due, probably, to patients' ages. Evaluation of the scoring system showed adequate detection of the scoring attribute, but some categories are redundant. ConclusionsThe FACT-Cx scale is made up of a set of items which, in general, adequately measures a one-dimensional structure. However, the scoring system appears to include redundancies. The properties associated with the reproductive ability item should be assessed in a sample that includes greater range in subjects' ages.

Health-related quality of life outcomes associated with four cisplatin-based doublet chemotherapy regimens for stage IVB recurrent or persistent cervical cancer: A Gynecologic Oncology Group study

Purpose To assess the differences in health-related quality of life (HRQL) of 4 cisplatin containing doublet chemotherapy combinations in women with advanced/recurrent cervical carcinoma. Methods Patients were randomized to three-week cycles of paclitaxel + cisplatin (PC); vinorelbine + C (VC); gemcitabine + C (GC); or topotecan + C (TC). We report HRQL results from data available on 434 eligible patients enrolled into this 513 patient trial. HRQL was assessed with the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) the FACT/Gynecologic Oncology Group (FACT/GOG) four-item neurotoxicity scale, and the 0–10 “worst pain” item from the Brief Pain Inventory, at baseline (pre-treatment), prior to beginning cycle 2, prior to beginning cycle 5, and at 9 months after enrollment. As reported by Monk et al. (2009) [13] VC, GC and TC were found not to be superior to PC with regard to progression-free survival or overall survival. Results The trial was terminated early due to planned interim futility analysis, reducing power for HRQL analysis from 85% to 55%. Patients receiving VC, GC and TC doublets did not report significantly different HRQL, neuropathy, or pain from those who received the PC (control) doublet. Patients receiving PC tended to report worse neuropathy during treatment than patients who received other doublets (especially GC and TC), but the differences were not statistically significant. Conclusion None of the 3 experimental doublets was different from PC in terms of HRQL during treatment. Long-term toxicity data are inconclusive. Except where patients may wish to reduce their risk of worsening pre-treatment neuropathy, PC remains the standard of care for this disease.

Quality of Life and Sexual, Bladder, and Intestinal Dysfunctions After Class III Nerve-Sparing and Class II Radical Hysterectomies

To compare quality of life and bladder, intestinal, and sexual dysfunctions in 2 groups of patients undergoing different types of radical hysterectomies (RHs). Patients with cervical cancer who underwent RH have been enrolled in a questionnaire-based study. Quality of life (QoL) and bladder, intestinal, and sexual dysfunctions were evaluated with the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx). Patients were grouped according to the type of RH: group 1, class II RH and group 2, class III nerve-sparing RH (NSRH). Of 157 women included in the study, 127 filled out the questionnaire. Overall, QoL score assessed with the FACT questionnaire did not differ significantly between the 2 groups. The FACT subscales assessing physical, functional, emotional, and social well-being did not differ significantly between the 2 groups, whereas the FACT-Cx subscales assessing disease-related symptoms in group 2 patients showed a significantly worse score (72 vs 66; P = 0.03). Evaluating singularly the 15 items of the Cx subscales assessing disease-related symptoms, we did not find any significant difference between the 2 groups, but only Cx1 ("I am bothered by discharge or bleeding from my vagina") was significantly worse in group 2 patients. At univariate analysis, we found that NSRH and adjuvant radiotherapy (RT) impact negatively on the FACT-Cx subscales regarding pelvic visceral function. However, at multivariate analysis, only adjuvant RT impact negatively. Patients submitted to class III NSRH did not present worse QoL and pelvic visceral dysfunctions when compared with class II RH. The RT seems to be a factor impacting negatively on bladder and sexual function.