Adjuvan Radyoterapi Uygulanan Endometrium Kanserli Hastalarda Yaşam Kalitesinin Değerlendirilmesi
Özet
The current study evaluates long-term quality of life and sexual function of patients with endometrial cancer who received adjuvant radiotherapy (RT). One hundred and forty-four patients with the diagnosis of endometrial carcinoma, who received adjuvant radiotherapy in Hacettepe University Faculty of Medicine Department of Radiation Oncology between 2000 and 2009, were included in this study. The mean age of the patients was 65 years (range: 48-88 years). Quality of life was evaluated by using EORTC QLQ-C30 questionnaire and the CX-24 module. In 136 cases (94%), surgery was total abdominal hysterectomy/bilateral salphingo-oophorectomy (TAH + BSO), while in 120 patients (83.3%) pelvic + paraaortic lymph node dissection and in 17 patients (12%) only pelvic lymph node dissection was performed. Adjuvant radiotherapy was vaginal brachytherapy (BRT) in 76 patients (53%), external beam radiation therapy (ERT) in 52 patients (36%), and ERT + vaginal BRT in 16 patients (11%). Compared to patients who received vaginal BRT alone, symptom score, lymphedema, pain, and diarrhea was higher and physical functioning, role functioning and sexual enjoyment were significantly lower in patients undergoing ERT. There was not an additional effect of vaginal BRT added to ERT on worsening symptom scales and sexual functions. Physical functioning was worse in patients who received systemic chemotherapy. In patients younger than 65 years, body image, sexual activity and sexual worry were significantly higher while fatigue were significantly higher in patients older than 65 years. While lymphedema in obese patients was higher, cognitive functioning and role functioning was significantly high with normal weight. With increasing stage of the disease, lymphedema, peripheral neuropathy, fatigue, pain, and diarrhea increased. As the elapsed time after the treatment, deterioration in body image and emotional functioning were observed. External RT negatively affects quality of life and sexual functions in endometrial cancer patients. Vaginal brachytherapy provides a higher quality of life. To be within the normal range of body mass index in patients with endometrial cancer will improve the quality of life.
