Late Persistant Substantial Patient Reported Symptoms (Lapers), After Radio(Chemo)Therapy And Mri Image-Guided Adaptive Brachytherapy For Locally Advanced Cervical Cancer In The Embrace Study

INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER(2019)

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摘要
Objectives To report on patterns of morbidity from the EMBRACE prospective study on MRI image-guided, adaptive brachytherapy in locally advanced cervical cancer, using a novel method to identify patients with LAte, PERsistent, Substantial treatment-related symptoms (LAPERS). Methods EORTC QLQ-C30 + CX24 were analyzed in 657 patients out of 1416 patients within the EMBRACE study who had a valid baseline, 3 months’ assessment and at least 3 additional late follow-ups. A LAPERS event for an individual patient was defined when the median scoring over late follow-ups was “quite a bit” or “very much” (substantial symptoms). For organ-related symptoms baseline morbidity was taken into account by requiring the median to be worse than the minimum of baseline and 3 months scoring (treatment-related). In addition, crude incidences and median prevalence rates were calculated. Results Median follow-up was 42 months (IQR 30–59). LAPERS, crude incidence and median prevalence rates of substantial symptoms are presented in table 1; and examples including prevalence rates in figure 1. LAPERS/crude incidence ratios lower than 0.1 indicate that Conclusions LAPERS method provides complementary information to prevalence and incidence rates. LAPERS provides a more appropriate tool for a valid assessment of patients’ burden of substantial toxicity.
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关键词
advanced cervical cancer,adaptive brachytherapy,mri,late persistant substantial patient,image-guided
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