Journal
RADIOTHERAPY AND ONCOLOGY
Volume 127, Issue 3, Pages 440-448Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.radonc.2018.03.009
Keywords
Locally advanced cervical cancer; Fatigue; Insomnia; Hot flashes; Radiochemotherapy; MRI-guided adaptive brachytherapy
Funding
- Medical University of Vienna
- Nucletron
- Elekta company
- Varian Medical Systems
- Austrian Federal Ministry of Science, Research and Economy
- Austrian Foundation for Research, Technology, and Development
- Danish Cancer Society and CIRRO - The Lundbeck Foundation Center for Investigational Research in Radiation Oncology
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Objective: To evaluate the pattern of manifestation of fatigue, insomnia and hot flashes within the prospective, observational, multi-center EMBRACE study. Methods: Morbidity was prospectively assessed according to CTCAE v.3 and patient-reported outcome with EORTC QLQ-C30/CX24 at baseline and regular follow-up. Analyses of crude incidence, prevalence rates and actuarial estimates were performed. Results: A total of 1176 patients were analyzed with a median follow-up of 27 months. At baseline, CTCAE G1/G2 prevalence rates for fatigue were 29%/6.2%, for insomnia 18%/3.1% and for hot flashes 7.9%/1.6% with respective 3-year prevalence rates of 29%/6.8%, 17%/4.4% and 19%/5.9%. Similar patterns of manifestation were seen in patient-reported EORTC outcomes. The 3-year actuarial estimates for G >= 3 CTCAE fatigue, insomnia and hot flashes were 5.5%, 4.7% and 1.9%. Younger age was associated with significantly higher risk for fatigue, insomnia and hot flashes. Conclusion: Fatigue, insomnia and hot flashes occurred mainly in the mild to moderate range. Fatigue and insomnia were already present before treatment and showed minor fluctuations or recovery during follow-up, whereas hot flashes showed a considerable increase after treatment. More research is needed to evaluate contributing risk factors in order to define intervention strategies. (C) 2018 Elsevier B.V. All rights reserved.
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