Quality of life in women with cervical precursor lesions and cancer: a prospective, 6-month, hospital-based study in China

Abstract

The overall survival of patients with cervical cancer has improved due to detection at an early stage and availability of comprehensive treatments in China. As patients' lives prolonged, it is important to understand their health-related quality of life (QoL) during and after treatment. We used the EQ-5D questionnaire to assess QoL of 194 patients with cervical lesions at Sichuan University West China Second Hospital between May 2010 and January 2011. Patients were surveyed before primary treatment and at 1, 3, and 6 months after primary treatment. Results showed a consistent decline in EQ-5D scores in the spectrum of cervical lesions at each time point after treatment (all P < 0.05). For patients with precursor lesions, there was an increasing trend along the timeline of treatment (P < 0.01). For patients with early-stage cervical cancer, EQ-5D scores declined in the first month (P = 0.01) and gradually increased to higher levels at 6 months post-treatment than those before treatment (P < 0.01). EQ-5D scores followed a similar trend in patients with advanced cervical cancer (P = 0.04), though they did not statistically rebound after 6 months (0.84 ± 0.19 vs. 0.86 ± 0.11, P = 0.62). Regarding advanced cervical cancer, EQ-5D scores for women above 40 years of age appeared to recover more rapidly and reached higher levels than those for women below 40 years (P = 0.03). Caution and extra care are recommended in the early period of cervical cancer treatment given the slight deterioration in the QoL, and in particular, for younger cervical cancer patients. Our study implies that health care providers may need to improve the health-related QoL of cervical cancer patients.

Californium-252 neutron brachytherapy combined with external pelvic radiotherapy plus concurrent chemotherapy for cervical cancer: a retrospective clinical study

“…Toxicity classified as grade 3 or higher was considered severe. The irradiation-related adverse effects included bone marrow suppression, gastrointestinal reactions, irradiation-related enteritis, intestinal obstruction, intestinal fistula, irradiation-related cystitis, and urinary fistula [ 7 , 9 , 13 , 15 ].…”

“…The 5-year survival rate of patients with stage II or III disease who receive concurrent chemoradiotherapy ranged from 53% to 74%; however, the 5-year survival rate of patients with stage IV disease was only 20% to 30% [ 5 ]. Different treatment algorithms affect surviving women to varying degrees, and radiotherapy is associated with longer-term adverse effects than surgery or chemotherapy [ 6 , 7 ]. Several studies have shown that adding brachytherapy to the treatment protocol results in prolonged survival for patients with cervical cancer [ 8 – 11 ].…”

Responsiveness and minimal clinically important difference of the EQ-5D-5L in cervical intraepithelial neoplasia: a longitudinal study

“…In all patients, the positive changes in the index value and EQ VAS also coincided with other studies. A prospective study of Chinese patients with CIN conducted by Zhao and colleagues found that EQ-5D scores 1 month after treatment were signi cantly better than at baseline [6]. Therefore, we considered that post-surgical changes to patients' health can be qualitatively judged by the change in EQ-5D-5L score.…”

Responsiveness and minimal clinically important difference of the EQ-5D-5L in cervical intraepithelial neoplasia: a longitudinal study

“…In all patients, the positive changes in UI and EQ VAS were also found in other studies. A prospective study in Chinese CIN patients conducted by Zhao et al expressed that the EQ-5D scores of 1 month after treatment was significantly better than the baseline [31]. Therefore, we considered that changes in health of CIN patients caused by surgical treatment can be qualitatively judged by the score change of the EQ-5D-5L.…”

“…The good news is that surgical treatment is a definitive treatment for CIN, and the cure rate is very high [5], so it as an effective measure to prevent the occurrence of invasive cervical cancer. Along with health-related quality of life (HRQoL) is increasing being concerned, patient-reported outcomes (PROs) are clinical endpoints other than survival, such as the EuroQol five-dimensional questionnaire (EQ-5D) [6].…”