Physician assessed and patient reported lower limb edema after definitive radio(chemo)therapy and image-guided adaptive brachytherapy for locally advanced cervical cancer: A report from the EMBRACE study.
Radiother Oncol
; 127(3): 449-455, 2018 06.
Article
en En
| MEDLINE
| ID: mdl-29631933
ABSTRACT
BACKGROUND/PURPOSE:
To evaluate the pattern of manifestation and risk factors for lower limb edema (LLE) within the prospective, observational, multi-center EMBRACE study on radiochemotherapy and MRI-guided brachytherapy in locally advanced cervical cancer (LACC). MATERIAL/METHODS:
LLE was prospectively assessed according to the physician-reported CTCAE v.3 and patient-reported EORTC QLQ-CX24 questionnaire at baseline and regular follow-up.RESULTS:
In total, 1176 patients were evaluated with a median follow-up of 27â¯months. Actuarial analyses revealed 3/5-year estimates of 27%/31% of CTCAE Gâ¯≥â¯1, 6.1%/6.6% of Gâ¯≥â¯2 and 0.5%/0.5% for Gâ¯≥â¯3. Prevalence rates for Gâ¯≥â¯1 LLE at 3â¯months, 1, 3 and 5â¯years after end of treatment were 7%, 12%, 12%, 15% for physician-assessed and 25%, 30%, 30%, 34% for any patient-reported symptoms and showed a steady increase over time. Invasive lymph node staging and obesity at diagnosis are independent significant risk factors for Gâ¯≥â¯1 LLE, whereas nodal boost has no impact. Extended radiation fields including para-aortic and/or inguinal nodes show a tendency to increase the risk.CONCLUSION:
Severe LLE after definitive radiochemotherapy in LACC is rare. However, the risk for mild LLE is considerable, and related to patient-, diagnostic- and treatment characteristics. Less invasive diagnostic surgical procedures or non-invasive assessment, less invasive radiotherapy management and active rehabilitation are important pathways for future developments.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Braquiterapia
/
Neoplasias del Cuello Uterino
/
Edema
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Qualitative_research
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Radiother Oncol
Año:
2018
Tipo del documento:
Article
País de afiliación:
España