Main Session
Sep
28
PQA 04 - Breast Cancer, Patient Reported Outcomes/QoL/Survivorship, Functional Radiation Medicine, Hematologic Malignancies, Palliative Care, and International/Global Oncology
2767 - Prospective Evaluation of Quality of Life and Clinicopathological Predictors in Locally Advanced Cervical Cancer Treated with Definitive Chemoradiotherapy and CT-Guided Brachytherapy
Presenter(s)
Keerthiga Karthikeyan, MBBS, DNB - Mahatma Gandhi Cancer Hospital & Research Institute, Visakhapatnam, visakhapatnam, Andhra Pra
K. Karthikeyan, P. S. Bhattacharyya, K. C. Patro, V. K. Pilaka, and M. A; Mahatma Gandhi Cancer Hospital and Research Institute, Vishakapatnam, India
Purpose/Objective(s):
We hypothesized that definitive chemoradiotherapy (CCRT) followed by CT-guided brachytherapy would result in a clinically meaningful improvement in patient-reported global health status (GHS) by 3 months post-treatment, and that this recovery would be independently influenced by FIGO stage and age, rather than initial tumor volume or hematologic parameters. This prospective longitudinal study aimed to evaluate early changes in quality of life (QOL) and identify clinicopathological predictors of GHS in patients with locally advanced cervical cancer (LACC).Materials/Methods:
Ninety-three patients with FIGO 2018 stage IIB–IIIC2 cervical cancer were enrolled (April–Oct 2021); 80 completed the 3-month follow-up. Treatment included 50.4 Gy (28 fractions) 3D-CRT with concurrent weekly cisplatin (40 mg/m²) followed by CT-based image-guided brachytherapy. Primary endpoint: Change in EORTC QLQ-C30 GHS from baseline to 3 months post-treatment. Secondary endpoints included functional/symptom domains (QLQ-C30, CX24), financial toxicity (COST-FACIT Version 2), and tumor regression via weekly transvaginal sonography (TVS). Multivariate linear regression identified independent predictors of GHS.Results:
Median age was 52.9 years; 57% of patients had Stage IIIC2 disease. GHS scores demonstrated a robust improvement from baseline (46.1 ± 11.4) to 3 months (91.6 ± 6.9; p<0.001), exceeding the threshold for minimal clinically important difference. All functional domains improved significantly (p<0.001). TVS regression was significant, with the median largest diameter decreasing from 5.05 cm at Week 1 to 1.95 cm at Week 4 (p<0.001). Financial toxicity was prevalent but mild (Grade 1), with 90% of patients supported by government schemes. Multivariate analysis identified FIGO stage and age as the only independent predictors of GHS; tumor volume and hemoglobin were not predictive. Table 1: Linear regression analysis for the association between stage of cervical Ca and quality of health (EORTC-QLQ-30) and COST-FACITConclusion:
Definitive CCRT with CT-based brachytherapy results in rapid, significant QOL improvements and high clinical response rates in LACC. The identification of disease stage and age as primary drivers of recovery, independent of tumor burden, underscores the necessity for stage-specific survivorship interventions and psychosexual support in clinical practice.| Independent variable | Dependent variable | Correlation | Adjusted R2 | B (coefficient) | 95% confidence interval lower bound | 95% confidence interval upper bound | P value |
| Stage of Ca Cervix | Global health status | -0.549 | 0.294 | -13.082 | -17.186 | -8.978 | <0.001 |
| Physical functioning | -0.201 | 0.030 | -4.593 | -9.203 | 0.017 | 0.051 | |
| Role functioning | -0.649 | 0.415 | -27.337 | -33.932 | -20.743 | <0.001 | |
| Emotional functioning | -0.562 | 0.309 | -10.624 | -13.842 | -7.405 | <0.001 | |
| FACIT score | -0.156 | 0.012 | -1.238 | -2.999 | 0.523 | 0.166 | |
| Pain | -0.074 | -0.005 | -2.230 | -8.426 | 3.966 | 0.477 |