TY - JOUR
T1 - A systematic review of the impact of contemporary treatment modalities for cervical cancer on women's self-reported health-related quality of life
AU - Wiltink, L. M.
AU - King, M.
AU - Müller, F.
AU - Sousa, M. S.
AU - Tang, M.
AU - Pendlebury, A.
AU - Pittman, J.
AU - Roberts, N.
AU - Mileshkin, L.
AU - Mercieca-Bebber, R.
AU - Tait, M.-A.
AU - Campbell, R.
AU - Rutherford, C.
PY - 2020
Y1 - 2020
N2 - Purpose: Given the high survival rate of cervical cancer patients, understanding women’s health-related quality of life (HRQL) during and after treatment is of major clinical importance. We conducted a systematic review to synthesize all available evidence about the effects of each contemporary treatment modality for cervical cancer on all dimensions of women’s HRQL, including symptoms, functioning, and global HRQL. Methods: We searched four electronic databases from January 2000 to September 2019, cross-referenced and searched by author name for studies of patients treated for cervical cancer that reported patient-reported outcomes (PROs) before treatment and with at least one post-treatment measurement. Two independent reviewers applied inclusion and quality criteria and extracted findings. Studies were categorized by treatment to determine specific treatment effects on PROs. Results were narratively summarized. Results: We found twenty-nine papers reporting 23 studies. After treatments with curative intent for early or locally advanced disease, lymphedema, diarrhea, menopausal symptoms, tight and shorter vagina, pain during intercourse, and sexual worries remained long-term problems; however, sexual activity improved over time. HRQL and psychological distress were impacted during treatment with also worsening of global HRQL but improved 3–6ÃÂ months after treatment. In patients with metastatic or recurrent disease, pain improved during palliative treatment or remained stable, with no differences in global HRQL found over time. Conclusion: Whereas most symptoms worsen during treatment and improve in the first 3ÃÂ months after completing treatment, symptoms like lymphedema, menopausal symptoms, and sexual worries develop gradually and persist after curative treatment. These findings can be used to inform clinical practice and facilitate communication and shared decision-making. More research is needed in very early cervical cancer and the impact of fertility sparing therapy on PROs.
AB - Purpose: Given the high survival rate of cervical cancer patients, understanding women’s health-related quality of life (HRQL) during and after treatment is of major clinical importance. We conducted a systematic review to synthesize all available evidence about the effects of each contemporary treatment modality for cervical cancer on all dimensions of women’s HRQL, including symptoms, functioning, and global HRQL. Methods: We searched four electronic databases from January 2000 to September 2019, cross-referenced and searched by author name for studies of patients treated for cervical cancer that reported patient-reported outcomes (PROs) before treatment and with at least one post-treatment measurement. Two independent reviewers applied inclusion and quality criteria and extracted findings. Studies were categorized by treatment to determine specific treatment effects on PROs. Results were narratively summarized. Results: We found twenty-nine papers reporting 23 studies. After treatments with curative intent for early or locally advanced disease, lymphedema, diarrhea, menopausal symptoms, tight and shorter vagina, pain during intercourse, and sexual worries remained long-term problems; however, sexual activity improved over time. HRQL and psychological distress were impacted during treatment with also worsening of global HRQL but improved 3–6ÃÂ months after treatment. In patients with metastatic or recurrent disease, pain improved during palliative treatment or remained stable, with no differences in global HRQL found over time. Conclusion: Whereas most symptoms worsen during treatment and improve in the first 3ÃÂ months after completing treatment, symptoms like lymphedema, menopausal symptoms, and sexual worries develop gradually and persist after curative treatment. These findings can be used to inform clinical practice and facilitate communication and shared decision-making. More research is needed in very early cervical cancer and the impact of fertility sparing therapy on PROs.
KW - cancer
KW - cervix uteri
KW - chemotherapy
KW - quality of life
KW - radiotherapy
KW - surgery
UR - https://hdl.handle.net/1959.7/uws:57705
U2 - 10.1007/s00520-020-05554-2
DO - 10.1007/s00520-020-05554-2
M3 - Article
SN - 0941-4355
VL - 28
SP - 4627
EP - 4644
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 10
ER -