NEW YORK (Reuters Health), Aug 24 - Endometrial cancer patients who undergo vaginal brachytherapy have a better quality of life (QoL) than those who receive external beam pelvic radiotherapy, according to Dutch researchers.
As lead investigator, Dr. Remi A. Nout of Leiden University Medical Center told Reuters Health, "We found significant and clinically relevant differences, both immediately after treatment, and during the subsequent two years."
In the July 20 issue of the Journal of Clinical Oncology, Dr. Nout and colleagues report on 348 women with a mean age of about 70 years who are participating in a randomized trial of these two treatment approaches.
In this first analysis of patient-reported QoL during the first two years after treatment, the researchers found marked differences between the groups.
Compared with women who received brachytherapy, the pelvic radiotherapy group had significantly more bowel symptoms such as diarrhea and fecal leakage. These women also reported a significantly higher need to be close to a toilet, which resulted in limitation of daily activities and social functioning.
"These differences remained stable with additional follow-up," the authors said.
Overall, patient functioning was lowest after surgery and reached a plateau after 12 months. During this period there was a trend toward less fatigue in the brachytherapy group.
At baseline -- roughly a month after surgery -- only 15% of the responding patients indicated that they were sexually active. Activity increased significantly to 39% during the first year, with no significant differences between the treatment groups.
"We concluded," Dr. Nout said, "that short-term health-related QoL was significantly better after vaginal brachytherapy than external beam pelvic radiotherapy."
Although this benefit will have to be balanced against the results of the efficacy analysis, the researchers point out that from a QoL perspective, vaginal brachytherapy should be the preferred treatment for patients with high- to intermediate-risk endometrial cancers.
By David Douglas
J Clin Oncol 2009;27:3547-3556.
Last Updated: 2009-08-14 16:05:10 -0400 (Reuters Health)
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