Treatment Investigation And QOL Analysis Of Patients With IB2-?A Stage Cervical Malignant Tumor

Objective:To compare the overall survival,long-term complications and quality of life of pre-operative brachytherapy and chemotherapy followed by radical surgery with standard chemo-irradiation in stage IB2 and IIA cervical cancer.To analysis the influence factor of QOL and investigate the best treatment.To provide the basis of eliminating the unhealthy factor in recovering period with cervical cancer.Methods:Retrospectively review the patients between June 2006 and June 2012 with IB2 and ?A(FIGO 2000)at Tianjin central Obstetrics and Gynegological Hospital.105 patients in operation group(OT group),54 patients in chemo-irradiation group(ChemoRT group).The oncologic outcomes and complications between these two groups were compared;After 1-6 years,OT group was devided into two groups which one group has operation only,the other has post-operation adjuvant therapy.QOL of patients were measured using the Functional Assessment of Cancer Therapy for Research and Treatment of Cervix Cancer Quality of Life Questionnaire.Multivariate analysis is used in the three groups and LSD is used in both groups.Multiple linear regressions analysis was used to explore influencing factors of quality of life among cervical cancer patients.Results:1.There were more proctitis and cystitis(29.6%vs 4.76%),myelosuppression(37%vs 17.1%)and symptomatic vaginal stenosis(35.2%vs 12%)in the chemoRT group compared with the OT group.While there were more urological symptoms(32.4%vs 14.8%)in the OT group compared with the chemoRT group.2.Median follow up was 24 months(range 10 to 72 months),In CCRT group,3-year actuarial overall survival and disease free survival were respectively 95%and 90%.In OT group,3-year overall survival and disease free survival were respectively 86%and 84%.There is no significant difference between two groups.3.Quality of life of patients with cervical cancer were at a relatively middle or higher level(FACT-Cx=114.5±12.3).Among the factor scores of five dimensions of FACT-Cx,the lowest scores were the social function dimension(seores2.52±0.55),Emotional function dimension was low(2.78 ± 0.56).4.There is no different in Quality of the of patiens treated with standard chemoirradiation,radical hysterectomy and lymphadenectomy and post-operation adjuvant chemo-radiation followed radical hysterectomy and lymphadenectomy.The scores of FACT-Cx and FACT-G are similar among these three groups.5.Multiple linear regression analysis showed that marriage status and medical insurance were the influencing factors of quality of life among cervical cancer patients.The impact factors varied among different groups.Conclusions:1.Pre-operative brachytherapy with chemotherapy followed by radical surgery has similar survival to chemoirradiation in stage IB2 to IIA cervical cancer but has better side effects profile.2.Quality of life of patients with cervical cancer was at a relatively middle or higher level.Patients have bad quality of life in social function.3.There is no different in Quality of life of patiens treated with different methods.4.Quality of life among cervical cancer patients were influenced by many factors.We shoud pay more attention to patients who have heavy fiancial burden,unsatisfied with family relationship,single and without medical insurance.Specific intervention should be used to improve their quality of life.5.Individualized combination therapy should be taken according to the age,fiancial burden and QOL expected of patients.