scholarly journals Five-year quality of life of endometrial cancer patients treated in the randomised Post Operative Radiation Therapy in Endometrial Cancer (PORTEC-2) trial and comparison with norm data

2012 ◽  
Vol 48 (11) ◽  
pp. 1638-1648 ◽  
Author(s):  
Remi A. Nout ◽  
Hein Putter ◽  
Ina M. Jürgenliemk-Schulz ◽  
Jan J. Jobsen ◽  
Ludy C.H.W. Lutgens ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Endometrial Cancer ◽  
Cancer Patients

scholarly journals The role of a clinical psychologist in the system of medical and psychological support of cancer patients at radiation therapy stage (аnalytical review of literature and own clinical data)

2020 ◽  
Vol 28 (3) ◽  
pp. 255-272
Author(s):  
O. O. Kyrylova ◽  
V. P. Starenkiy ◽  
S. V. Artiukh ◽  
N. E. Prokhach ◽  
T. H. Kiian
Keyword(s):  
Radiation Therapy ◽  
Endometrial Cancer ◽  
Cancer Patients ◽  
Emotional State ◽  
Life Quality ◽  
Psychological Status ◽  
Psychological State ◽  
Oncology Patients ◽  
Psychotherapeutic Interventions

Background. Being diagnosed with cancer is a dramatically stressful condition for a human. Radiation therapy (RT), which is an essential of combination antineoplastic treatment, can cause physical and emotional state changes. Realizing these changes is an additional stress factor that results in impaired life quality of a cancer patient as well refusal to undergo further treatment. At present, there is no distinct system of providing psychological aid for cancer patients in Ukraine. Purpose. To carry out analysis and generalization of research literature data in terms of providing psychological aid for cancer patients at RT stage and to present own findings of psychological study enrolling 55 female patients diagnosed with endometrial cancer at RT stage at SO «Grigoriev Institute for Medical Radiology and Oncology» within the period from 2015 to 2018. Materials and methods. The literature review involved available contributions obtained via literature search in domestic (Vernadsky National Library of Ukraine) and foreign databases (Scopus, Web of Science Core Collection, PubMed, BMC, ScienceDirect, Wiley Online Library, RNB). Fifty-five patients with endometrial cancer of stage I–II (T1b-c N0 M0 – T2a -b N0 M0) underwent clinical and laboratory examination. The diagnosis of adenocarcinoma was confirmed by means of a histologic study. All patients underwent panhysterectomy and postsurgery course of distant gamma-therapy on “РОКУС-АМ” device by split fractionation. Fifteen patients were provided with psychological correction at RT stage. In order to assess life quality, SF-36 (Health Status Survey) was used. An assessment of the severity of psychosomatic disorders in patients with endometrial cancer was made by means of EORTC QLQ-C30 survey. Results. The paper analyzes psychological aid provided to oncology patients at radiation therapy stage in Ukraine and overseas. It presents the peculiarities of patients’ psychological responses during irradiation and possible consequences of higher mental function impairment. The targets of psychological correction and factors influencing life quality of a patient have been considered as well as the effectiveness of psychotherapeutic interventions outcomes of different approaches has been provided. The study states that, currently, medical and psychological follow-up of cancer patients does not consist only in reassuring talk and drug correcting of their psychological state aimed to reduce distress, anxiety and depression level, but also in psychocorrection, psychoeducation, the access to psychotherapeutic groups, individual psychotherapy. The efficiency of applying own developed schemes of medical and psychological correction of emotional state of women with EC is presented, the use of which has made it possible to reduce the manifestations of sleep disorders, cognitive function and fatigue. Conclusions. Following a differentiated strategy when choosing methods of psychological aid for oncology patients and their families at radiation therapy stage via psychocorrection of emotional, cognitive and behavioral spheres, psychoeducation or psychotherapeutic interventions will make it possible to significantly improve their psychological status and quality of life.

Intensive versus minimalist follow-up in patients treated for endometrial cancer: A multicentric randomized controlled trial (The TOTEM study—NCT00916708).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 5506-5506
Author(s):  
Paolo Zola ◽  
Giovannino Ciccone ◽  
Elisa Piovano ◽  
Luca Fuso ◽  
Elena Peirano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Overall Survival ◽  
Endometrial Cancer ◽  
Cancer Patients ◽  
Early Recognition ◽  
Controlled Trial ◽  
Physical And Mental Health ◽  
Randomized Controlled

5506 Background: Intensive follow-up in cancer patients, which absorbs a lot of health system resources and can be a source of increased stress for patients, are often proposed on the assumption that an early recognition of relapse will translate in better outcomes. In endometrial cancer few randomized controlled trials were conducted to assess the role of a reduced number of the scheduled visits and of different settings of the follow-up, but did not investigate the contribution of routine serum, cytological or imaging follow-up investigations in improving overall survival or quality of life. The TOTEM study was planned to compare an intensive (INT) vs minimalist (MIN) 5- year follow-up regimen in endometrial cancer patients in terms of overall survival (OS). Methods: Patients surgically treated for endometrial cancer, in complete clinical remission confirmed by imaging, FIGO stage I-IV, were stratified by center and in low (LoR) or high (HiR) risk of recurrence and then randomized to INT or MIN hospital-based follow-up regimens. The main study hypothesis was to demonstrate an improvement from 75% to 80% (expected hazard ratio, HR = 0.78) of the 5-year OS with the INT regimen. Secondary objectives were to compare relapse free survival (RFS), health-related quality of life (HRQL) assessed at baseline, at 6 and 12 months and then yearly (with the SF-12 Physical and Mental Health Summary Scale) and costs. Results: 1884 patients were randomized in 42 centers between 2008 and 2018, and 1847 patients were available for the final analysis (60% LoR). Compliance with the follow-up scheduled visits was 75.3%, similar between INT (74.7%) and MIN (75.9%) arms, whereas the mean number of recorded exams (laboratory or imaging) was markedly higher in the INT than in the MIN arms (9.7 vs 2.9, p < 0.0001). After a median follow-up of 66 months, the overall 5-year OS was 91.3%, 90.6% in the INT and 91.9% in the MIN arms, respectively (HR = 1.12, 95%CI 0.85-1.48, p = 0.429). Comparing the INT vs MIN arms, the 5-year OS were 94.1% and 96.8% (HR = 1.48, 0.92-2.37, p = 0.104) in the LoR and 85.3% and 84.7% (HR = 0.96, 0.68-1.36, p = 0.814) in the HiR group. No relevant differences emerged in RFS between INT and MIN regimens, (HR = 1.13, 0.87-1.48, p = 0.365). At the time of the relapse most women were asymptomatic (146/228, 64.0%), with a tendency of higher proportions in the INT than in the MIN arm, both in the LoR group (78.8% vs 61.1%, p = 0.070) and in the HiR one (64% vs 60%, p = 0.754). HRQL was available only for a subgroup of patients (50% at baseline) and did not differ between arms. Conclusions: Intensive follow-up in endometrial cancer treated patients showed a weak and uncertain advantage in detecting earlier asymptomatic relapses but did not improve OS, even in HiR patients, nor influenced HRQL. Frequent routine use of imaging and laboratory exams in these patients should be discouraged. Clinical trial information: NCT00916708.

scholarly journals Predictive factors of posttreatment fracture by definitive radiotherapy for uterine cervical cancer

2020 ◽  
Author(s):  
Kazuki Ishikawa ◽  
Tsuneo Yamashiro ◽  
Takuro Ariga ◽  
Takafumi Toita ◽  
Wataru Kudaka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Clinical Characteristics ◽  
Univariate Analysis ◽  
Uterine Cervical Cancer

Abstract Purpose Fractures are known to shorten life expectancy and worsen the quality of life. The risk of fractures after radiation therapy in cervical cancer patients is known to be multifactorial. In this study, we examined risk factors for fractures in cervical cancer patients, especially by evaluating bone densities and DVH parameters for fractured bones. Materials and Methods For 42 patients, clinical characteristics, pretreatment CT bone densities, and radiation dose were compared between patients with and without fractures. Results Posttreatment fractures occurred in 25 bones among ten patients. Pretreatment CT bone densities were significantly lower in patients with fractures (P < 0.05–0.01 across sites, except for the ilium and the ischium). Although DVH parameters were also significantly associated with fractures in univariate analysis, only CT densities were significantly associated with fractures in multivariate analysis. Conclusion Pretreatment CT densities of spinal and pelvic bones, which may reflect osteoporosis, have a significant impact on the risk for posttreatment fractures.

Reversal of anorexia with megestrol acetate (MA): Impact on quality of life (QoL) in non-metastasic lung cancer patients (pts) undergoing radiation therapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18613-18613 ◽  
Author(s):  
J. Pardo ◽  
A. Mena ◽  
A. Monleon ◽  
V. Macias ◽  
J. Sole ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Life Questionnaire ◽  
Negative Effects ◽  
Lung Cancer Patients ◽  
Related Quality ◽  
The Difference

18613 Background: Anorexia is a common and major problem in cancer patients. Its ethiology is multifactorial and has negative effects on pts QoL. Up to 30% of non-metastasic lung cancer pts receiving radiotherapy will develop anorexia during treatment. We conducted a randomized trial comparing the efficacy of two different doses of MA. The results of the first 130 pts included, presented at ASCO 2003, indicated that MA at doses of 600 mg/day is significantly more effective in the treatment of anorexia in these pts than low doses (320 mg/day) of MA. Here we present the results of the quality of life sub-study which purpose is to evaluate the effect of reversing anorexia in pts health related quality of life (HRQOL). Methods: From February 1999 to April 2003, 160 non-mestastatic lung cancer pts who developed anorexia during radiotherapy were randomized to receive either 320 mg/day or 600 mg/day of MA. All pts who developed anorexia filled up the EuroQuol (EQ-5D) quality of life questionnaire before treated with MA and the responders did it again when appetite was regained. The endpoint was improvement in pts HRQOL (defined as an increase > 5 mm in the EQVAS score between the second and first questionnaires). Results: The analysis of the EuroQuol (EQ-5D) questionnaires of the 131 pts who responded to treatment with MA shows that 106 pts (81%) had an improvement > 5 mm in the EQVAS score while 19 % did not. The difference is statistically significant (Binomial test: p < 0.0001). Regarding differences between the two series, 42 pts improved in the 320 mg arm versus 64 in the 600 mg arm which is not statistically significant (Fisher test: p = 0.501). Conclusions: Our results indicate that reversal of anorexia with MA has a clinically significant improvement in HRQOL in non-metastatic lung cancer pts undergoing radiation therapy. The absence of statistically significant differences between the two series may be due to the sample size. [Table: see text] No significant financial relationships to disclose.

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