eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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SCImago Journal & Country Rank

4/2022
vol. 14
 
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abstract:
Original paper

Quality of life and sexual functioning among endometrial cancer patients treated with one week adjuvant high-dose-rate vaginal brachytherapy schedule

Giuseppe Facondo
1
,
Gianluca Vullo
1
,
Vitaliana De Sanctis
1
,
Cecilia Vitiello
2
,
Luciano Nieddu
2
,
Marco Alfò
2
,
Claudia Scaringi
3
,
Francesca De Felice
3
,
Margherita Rotondi
1
,
Flavia De Giacomo
1
,
Ilary Ruscito
4
,
Maurizio Valeriani
1
,
Mattia Falchetto Osti
1

1.
Radiotherapy Oncology, Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy
2.
Department of Statistical Sciences, Sapienza University of Rome, Rome, Italy
3.
Department of Radiotherapy, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
4.
Department of Medical and Surgical Sciences and Translational Medicine, Gynecology Unit, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy
J Contemp Brachytherapy 2022; 14, 4: 341–346
Online publish date: 2022/08/31
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Purpose
To examine quality of life (QOL) and sexual functioning in a series of patients with intermediate- and high-intermediate risk endometrial cancer, treated with exclusive adjuvant one week high-dose-rate (HDR) vaginal brachytherapy (VBT) schedule.

Material and methods
Between July 2008 and October 2013, 55 patients with diagnosis of endometrial cancer were treated with adjuvant exclusive VBT. All patients had undergone surgical treatment with a laparotomy approach before VBT. Post-operative VBT was administered 6-8 weeks after surgery. Treatment was delivered to vaginal vault using Nucletron HDR unit with iridium-192 source at a dose of 21 Gy/3 fractions of 7 Gy each, three times a week, every other day, prescribed at 0.5 cm depth of vaginal wall, and 3 cm in length from the apex. QOL was assessed using European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire Core-30 (QLQ-C30), and EORTC cancer-specific quality of life questionnaire (QLQ-CX24).

Results
Median follow-up time was 92 months (range, 42-162 months). Questionnaires were carried out respectively at 1, 3, 6, 12, 24, 36, 48, and 60 months after the end of BT. Response rate to questionnaires was 100% (n = 55). Nineteen patients (35%) answered all the questions of surveys, while 36 patients (65%) completed the surveys, except for questions on sex activity, vaginal function, and sex enjoyment. Longitudinal analysis during 5-year follow-up period showed a statistically significant trend towards worsening of fatigue, constipation, and diarrhea. Overall physical functioning and role functioning was not impaired after VBT. Over the time, sex enjoyment improved, except for elderly patients. For emotional functioning, sex worry and social functioning presented no significant time-related effect.

Conclusions
One week brachytherapy schedule to vaginal cuff is generally well-tolerated. QOL does not worsen after applying vaginal brachytherapy.

keywords:

endometrial carcinoma, brachytherapy, quality of life, sexual disfunction, fatigue

 
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