Health-related Quality of Life of Patients with Endometrial Cancer Who are Disease-free Following External Irradiation

Klee, David Machin Marianne

doi:10.1080/02841860152703436

Cited by 39 publications

(4 citation statements)

References 18 publications

(15 reference statements)

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“…These toxicities are known to have a negative impact on the quality of life of survivors. (9–11) In our study almost 30% of women receiving radiation had 1 or more comorbid medical conditions as show by the Charlson Index. Clinical trials usually exclude participants with several medical conditions.…”

Section: Discussionsupporting

confidence: 50%

“…(9;10) These toxicities include diarrhea, frequent voiding, rectovaginal fistulas, radiation proctitis, and fecal leakage. (11;12) Data available to counsel older patients on these and other effects of cancer treatment is limited. However, older patients experience more acute toxicities from radiation, putting them at higher risk for having late toxicities.…”

Section: Introductionmentioning

confidence: 99%

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The effect of postoperative beam, implant, and combination radiation therapy on GI and bladder toxicities in female Medicare beneficiaries with stage I uterine cancer

Samper‐Ternent

Asem²,

Zhang

et al. 2012

Journal of Geriatric Oncology

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Objective Determine the risk of late gastrointestinal (GI) and bladder toxicities in women treated for Stage I uterine cancer with postoperative beam, implant, or combination radiation. Methods The Surveillance, Epidemiology, and End Results (SEER) tumor registry and Medicare claims were used to estimate the risk of developing late GI and bladder toxicities by type of radiation received. Bladder and GI diagnoses were identified 6–60 months after cancer diagnosis. Cox-proportional hazard models were used to estimate risk of any late GI or bladder toxicity due to type of radiation received. Results A total of 3,024 women with uterine cancer diagnosed from 1992–2005 were identified for analysis with a mean age of 73.9 (Standard Deviation (SD) ± 6.5). Bladder and GI toxicities occurred most frequently in the combination group, and least in the implant group. After controlling for demographic characteristics, tumor grade, diagnosis year, SEER region, comorbidities, prior GI and bladder diagnosis, and chemotherapy, women receiving implant radiation had a 21% absolute decrease in GI toxicities compared to women receiving combination radiation (Hazard Ratio (HR) 0.79, 95% confidence interval (CI) 0.68–0.92). No differences were observed between those receiving beam and combination in GI (HR 1.01 (0.89–1.14)) and bladder (HR 0.95 (0.80–1.11)) toxicities. Conclusions Older women receiving combined radiation had the highest rates of GI and bladder toxicities, while women receiving implant radiation alone had the lowest rates. When selecting type of radiation for a patient, these toxicities should be considered. Counseling older women surviving cancer on late toxicities due to radiation must be a priority for physicians caring for them.

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Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

The effect of postoperative beam, implant, and combination radiation therapy on GI and bladder toxicities in female Medicare beneficiaries with stage I uterine cancer

Samper‐Ternent

Asem²,

Zhang

et al. 2012

Journal of Geriatric Oncology

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“…Limitations of prior research have included heterogeneous gynecologic populations and different adjuvant therapies [20–22]. Klee and Machin assessed 49 women with endometrial cancer who received adjuvant radiation therapy and concluded that most patients experience physical side effects and have overall lower QOL compared to a matched population of healthy women [20]. van de Poll-Franse noted good overall QOL in endometrial cancer survivors although QOL scores were lower in those who had received adjuvant therapy [22].…”

Section: Discussionmentioning

confidence: 99%

Quality of Life in Endometrial Cancer Survivors: What Does Obesity Have to Do with It?

Fader

Frasure

Gil

et al. 2011

Obstetrics and Gynecology International

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Objective. Most women with type I endometrial cancer (EC) are obese, increasing the risk of morbidity and mortality in this population. The study objective was to evaluate the impact of obesity on quality of life (QOL) and general health status in EC survivors with early-stage disease. Methods. A prospective ancillary analysis of stage I/II EC survivors. The association of BMI with QOL questionnaire variables measured with the functional assessment of cancer therapy (subscales: physical (PWB), functional (FWB), social, and emotional well-being) and the physical (PCS) and mental component summary subscales of the short-form medical outcomes survey was determined. Results. 152 women completed both questionnaires; 81% were obese. After multiple linear regression, BMI was inversely associated with PWB (P = .001), FWB (P = 0.048), and PCS (P = .001). Conclusions. Despite the good prognosis associated with early-stage EC, QOL, and physical health are not optimized in obese survivors. This paper highlights the importance of incorporating health-related QOL assessments and obesity interventions during the survivorship period.

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“…However, survivors experience symptoms and adverse effects associated with their cancer and cancer treatment, such as pain, fatigue, pelvic floor symptoms, and activities of daily living (ADL) impairments for 5–7 years after completing treatment (3, 11, 12, 26, 28, 29, 44). Approximately 50% of women with uterine cancer are obese (7).…”

Section: Introductionmentioning

confidence: 99%

Cancer-Related Impairments Influence Physical Activity in Uterine Cancer Survivors

Hammer

Brown

Segal

et al. 2014

Medicine &Amp; Science in Sports &Amp; Exercise

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Introduction The extent to which physical activity (PA) participation among uterine cancer survivors may be limited by physical and functional impairments (PFIs) related to cancer treatment is unknown. We sought to describe PA participation, characterize the prevalence of PFIs, and examine the association between PFI status and PA participation within this population. Methods We conducted a study using a mailed survey among uterine cancer survivors who received treatment at a university hospital. We asked about PA and PFIs using validated self-report questionnaires. PA was calculated using metabolic equivalent hours per week (MET-hrs·wk−1). PFI was defined as having one or more of the following symptoms: lower limb lymphedema (LLL), general pain, fatigue, or severe bladder, bowel, or pelvic issues. Ordinal logistic regression was used to quantify the odds ratio (OR) between PA and PFIs. Results The response rate to our survey was 43%. Among the 213 study participants, 40%, 13%, 13%, 12%, and 23% reported participating in <3.0, 3.0–8.9, 9.0–17.9, 18.0–26.9, and ≥ 27.0 MET-hrs·wk−1 of PA, respectively. Walking is the preferred mode of exercise for physically active uterine cancer survivors. 53% of survivors experience at least one PFI. The most common PFI is LLL (36.2%), followed by general pain (22.5%). The OR of PFI decreased as MET-hrs·wk−1 of PA increased (OR = 0.51, 95% CI: 0.31–0.84; P=.009). Conclusion The majority of uterine cancer survivors experience physical and functional impairments that significantly reduce the likelihood of PA participation. Physical activity recommendations for uterine cancer survivors should take into account treatment-related impairments that can affect PA participation.

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Health-related Quality of Life of Patients with Endometrial Cancer Who are Disease-free Following External Irradiation

Cited by 39 publications

References 18 publications

The effect of postoperative beam, implant, and combination radiation therapy on GI and bladder toxicities in female Medicare beneficiaries with stage I uterine cancer

The effect of postoperative beam, implant, and combination radiation therapy on GI and bladder toxicities in female Medicare beneficiaries with stage I uterine cancer

Quality of Life in Endometrial Cancer Survivors: What Does Obesity Have to Do with It?

Cancer-Related Impairments Influence Physical Activity in Uterine Cancer Survivors

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