Randomized trial results of quality of life comparing whole abdominal irradiation and combination chemotherapy in advanced endometrial carcinoma: A gynecologic oncology group study

Deborah Watkins Bruner, Andrea Barsevick, Chunqiao Tian, Marcus Randall, Robert Mannel, David E. Cohn, Joel Sorosky, Nick M. Spirtos

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Objective: To prospectively compare quality of life (QOL) outcomes in patients with advanced endometrial cancer treated with whole abdominal irradiation (WAI) or doxorubicin-cisplatin (AP) chemotherapy. Methods: Using the Fatigue Scale (FS), Assessment of Peripheral Neuropathy (APN), Functional Alterations due to Changes in Elimination (FACE), and Functional Assessment of Cancer Therapy-General (FACT-G), QOL was measured at: pre-treatment, end of treatment (EOT), and 3 and 6 months post-treatment. Results: 317 of 396 eligible patients provided a baseline QOL assessment. The AP arm produced a statistically significant survival benefit along with greater toxicities, including peripheral neuropathy persisting up to 6 months. WAI patients reported worse FS (p < 0.001) and FACE (p < 0.001) scores at EOT and poorer FACE scores 3 months post-treatment (p = 0.004) compared to AP patients. APN scores were significantly worse among AP patients at EOT, and 3 and 6 months post-treatment (p < 0.001 for all). There is no indication that FACT-G scores differed between the two arms at any assessment point. Conclusions: The trade-off for increased survival with AP is its potential for clinically significant peripheral neuropathy. This should be discussed with patients, particularly those who work with their hands or on their feet, in weighing therapeutic choices. Further research is needed to manage side effects having an enduring impact on QOL.

Original languageEnglish
Pages (from-to)89-100
Number of pages12
JournalQuality of Life Research
Volume16
Issue number1
DOIs
StatePublished - Feb 2007

Bibliographical note

Funding Information:
This study was supported by National Cancer Institute grants to the Gynecologic Oncology Group Administrative Office (CA 27469) and the Gynecologic Oncology Group Statistical and Data Center (CA 37517). The following member institutions participated in this study: University of Oklahoma, Columbus Cancer Council, University of Iowa Hospitals and Clinics, Women’s Cancer Council, University of Mississippi Medical Center, Duke University Medical Center, University of North Carolina School of Medicine, Abington Memorial Hospital, Walter Reed Army Medical Center, University of California Medical Center at Irvine, Washington University School of Medicine, Wake Forest University School of Medicine, Community Clinical Oncology Program, Tacoma General Hospital, University of Texas Southwestern Medical Center at Dallas, Colorado Gynecologic Oncology Group, P.C., Cooper Hospital/University Medical Center, Case Western Reserve University, University of Minnesota Medical School, University of California at Los Angeles, Rush-Presbyterian-St. Luke’s Medical Center, The Cleveland Clinic Foundation, Tufts-New England Medical Center, Wayne State University, University of Alabama at Birmingham, University of Chicago, Mayo Clinic, University of Indiana Medical Center, State University of New York at Stony Brook, Tampa Bay Cancer Consortium, Ellis Fischel Cancer Center, Johns Hopkins Oncology Center, Eastern Pennsylvania GYN/ONC Center, P.C., Thomas Jefferson University Hospital, Eastern Virginia Medical School, Medical University of South Carolina, University of Washington, University of Southern California at Los Angeles, University of Pennsylvania Cancer Center, Albany Medical College, State University of New York Downstate Medical Center, University of Massachusetts Medical School, University of Virginia, Brookview Research, Inc., University of Miami School of Medicine, Milton S. Hershey Medical Center, Georgetown University Hospital, University of Arizona Health Science Center, and University of Cincinnati.

Keywords

  • Ardaptation
  • Endometrial cancer
  • Health behavior
  • Neurotoxicity
  • Psychological

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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