Introduction/Background Pelvic radiotherapy is routinely used as a primary or adjuvant therapy for patients with gynecological malignancies. Radiation therapy techniques have developed from 3-dimensional-conformal radiation to Volumetric-modulated-arc-therapy (VMAT), with better sparing of normal tissus.
The aim of this study was to assess quality of life (QoL) and correlate it with dose–volume parameters of organ at risks in patients receiving VMAT irradiation for gynecological cancer.
Methodology A total of 28 patients(18 with endometrial cancer, 8 with cervical cancer and 2 with vulvar cancer) were interviewed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and its cervical cancer (EORTC QLQ-CX24),endometrial cancer (EORTC QLQ-EN24) or vulvar cancer (EORTC QLQ- VU34) module. QoL scores were classified as high, averge or low. Bladder incontinence or urgency, rectal discomfort or abdominal pain and sexual functioning were investigated and correlated with dose–volume parameters of organs at risk.
Results The median age at diagnosis was 55 years [30–86 years]. Sixteen patients (57%) received concomitant chemotherapy.
Sixty percent of patients reported high QoL. The rate of high grade bladder incontinence and bladder urgency was 21% and 39%, respectively. The rate of high grade rectal discomfort and abdominal pain was 29%. Among the patients engaged in sexual activity, 31% experienced a dyspareunia. We found a significant correlation between bladder V40 (absolute percentage of bladder volume that received a dose of 40 Gy) and bladder urgency (p=0.039, R 2 = 0.39). We also found a significant correlation between rectum V40 (absolute percentage of rectum volume that received a dose of 40 Gy) and rectal discomfort (p=0.0001, R 2 =0.63).
Conclusion Our study suggested that QoL during pelvic radiotherapy with VMAT technique has a favorable profile with minimal limitations of daily activities. In addition, QoL was correlated with dose–volume parameters. However, longer follow-up is required to better assess QoL profile.
Disclosures no conflict of interest to disclose
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