Late symptoms in long-term gynaecological cancer survivors after radiation therapy: a population-based cohort study
Identifieur interne : 004D94 ( Main/Exploration ); précédent : 004D93; suivant : 004D95Late symptoms in long-term gynaecological cancer survivors after radiation therapy: a population-based cohort study
Auteurs : H. Lind [Suède] ; A-C Waldenström [Suède] ; G. Dunberger [Suède] ; M. Al-Abany [Suède] ; E. Alevronta [Suède] ; K-A Johansson [Suède] ; C. Olsson [Suède] ; T. Nyberg [Suède] ; U. Wilder Ng [Suède] ; G. Steineck [Suède] ; E. Vall-Lundqvist [Suède]Source :
- British Journal of Cancer [ 0007-0920 ] ; 2011.
Abstract
We surveyed the occurrence of physical symptoms among long-term gynaecological cancer survivors after pelvic radiation therapy, and compared with population-based control women.
We identified a cohort of 789 eligible gynaecological cancer survivors treated with pelvic radiation therapy alone or combined with surgery in Stockholm or Gothenburg, Sweden. A control group of 478 women was randomly sampled from the Swedish Population Registry. Data were collected through a study-specific validated postal questionnaire with 351 questions concerning gastrointestinal and urinary tract function, lymph oedema, pelvic bones and sexuality. Clinical characteristics and treatment details were retrieved from medical records.
Participation rate was 78% for gynaecological cancer survivors and 72% for control women. Median follow-up time after treatment was 74 months. Cancer survivors reported a higher occurrence of symptoms from all organs studied. The highest age-adjusted relative risk (RR) was found for emptying of all stools into clothing without forewarning (RR 12.7), defaecation urgency (RR 5.7), difficulty feeling the need to empty the bladder (RR 2.8), protracted genital pain (RR 5.0), pubic pain when walking indoors (RR 4.9) and erysipelas on abdomen or legs at least once during the past 6 months (RR 3.6). Survivors treated with radiation therapy alone showed in general higher rates of symptoms.
Gynaecological cancer survivors previously treated with pelvic radiation report a higher occurrence of symptoms from the urinary and gastrointestinal tract as well as lymph oedema, sexual dysfunction and pelvic pain compared with non-irradiated control women. Health-care providers need to actively ask patients about specific symptoms in order to provide proper diagnostic investigations and management.
Url:
DOI: 10.1038/bjc.2011.315
PubMed: 21847122
PubMed Central: 3171018
Affiliations:
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Lind</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Waldenstrom, A C" sort="Waldenstrom, A C" uniqKey="Waldenstrom A" first="A-C" last="Waldenström">A-C Waldenström</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Department of Oncology, Sahlgrenska University Hospital</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dunberger, G" sort="Dunberger, G" uniqKey="Dunberger G" first="G" last="Dunberger">G. 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Olsson</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6"><institution>Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Nyberg, T" sort="Nyberg, T" uniqKey="Nyberg T" first="T" last="Nyberg">T. Nyberg</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Wilder Ng, U" sort="Wilder Ng, U" uniqKey="Wilder Ng U" first="U" last="Wilder Ng">U. Wilder Ng</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Steineck, G" sort="Steineck, G" uniqKey="Steineck G" first="G" last="Steineck">G. Steineck</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey=" Vall Lundqvist, E" sort=" Vall Lundqvist, E" uniqKey=" Vall Lundqvist E" first="E" last=" Vall-Lundqvist">E. Vall-Lundqvist</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff7"><institution>Department of Gynecologic Oncology, Karolinska University Hospital</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21847122</idno><idno type="pmc">3171018</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171018</idno><idno type="RBID">PMC:3171018</idno><idno type="doi">10.1038/bjc.2011.315</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">000087</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000087</idno><idno type="wicri:Area/Pmc/Curation">000087</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000087</idno><idno type="wicri:Area/Pmc/Checkpoint">002F01</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002F01</idno><idno type="wicri:Area/Ncbi/Merge">004606</idno><idno type="wicri:Area/Ncbi/Curation">004606</idno><idno type="wicri:Area/Ncbi/Checkpoint">004606</idno><idno type="wicri:doubleKey">0007-0920:2011:Lind H:late:symptoms:in</idno><idno type="wicri:Area/Main/Merge">004E30</idno><idno type="wicri:Area/Main/Curation">004D94</idno><idno type="wicri:Area/Main/Exploration">004D94</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Late symptoms in long-term gynaecological cancer survivors after radiation therapy: a population-based cohort study</title><author><name sortKey="Lind, H" sort="Lind, H" uniqKey="Lind H" first="H" last="Lind">H. Lind</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Waldenstrom, A C" sort="Waldenstrom, A C" uniqKey="Waldenstrom A" first="A-C" last="Waldenström">A-C Waldenström</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Department of Oncology, Sahlgrenska University Hospital</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dunberger, G" sort="Dunberger, G" uniqKey="Dunberger G" first="G" last="Dunberger">G. Dunberger</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Al Abany, M" sort="Al Abany, M" uniqKey="Al Abany M" first="M" last="Al-Abany">M. Al-Abany</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4"><institution>Department of Medical Physics, Karolinska University Hospital</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Alevronta, E" sort="Alevronta, E" uniqKey="Alevronta E" first="E" last="Alevronta">E. Alevronta</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Johansson, K A" sort="Johansson, K A" uniqKey="Johansson K" first="K-A" last="Johansson">K-A Johansson</name><affiliation wicri:level="1"><nlm:aff id="aff5"><institution>Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Olsson, C" sort="Olsson, C" uniqKey="Olsson C" first="C" last="Olsson">C. Olsson</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6"><institution>Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Nyberg, T" sort="Nyberg, T" uniqKey="Nyberg T" first="T" last="Nyberg">T. Nyberg</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Wilder Ng, U" sort="Wilder Ng, U" uniqKey="Wilder Ng U" first="U" last="Wilder Ng">U. Wilder Ng</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Steineck, G" sort="Steineck, G" uniqKey="Steineck G" first="G" last="Steineck">G. Steineck</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg</institution>, Gothenburg,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey=" Vall Lundqvist, E" sort=" Vall Lundqvist, E" uniqKey=" Vall Lundqvist E" first="E" last=" Vall-Lundqvist">E. Vall-Lundqvist</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff7"><institution>Department of Gynecologic Oncology, Karolinska University Hospital</institution>, Stockholm,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">British Journal of Cancer</title><idno type="ISSN">0007-0920</idno><idno type="eISSN">1532-1827</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background:</title><p>We surveyed the occurrence of physical symptoms among long-term gynaecological cancer survivors after pelvic radiation therapy, and compared with population-based control women.</p></sec><sec><title>Methods:</title><p>We identified a cohort of 789 eligible gynaecological cancer survivors treated with pelvic radiation therapy alone or combined with surgery in Stockholm or Gothenburg, Sweden. A control group of 478 women was randomly sampled from the Swedish Population Registry. Data were collected through a study-specific validated postal questionnaire with 351 questions concerning gastrointestinal and urinary tract function, lymph oedema, pelvic bones and sexuality. Clinical characteristics and treatment details were retrieved from medical records.</p></sec><sec><title>Results:</title><p>Participation rate was 78% for gynaecological cancer survivors and 72% for control women. Median follow-up time after treatment was 74 months. Cancer survivors reported a higher occurrence of symptoms from all organs studied. The highest age-adjusted relative risk (RR) was found for emptying of all stools into clothing without forewarning (RR 12.7), defaecation urgency (RR 5.7), difficulty feeling the need to empty the bladder (RR 2.8), protracted genital pain (RR 5.0), pubic pain when walking indoors (RR 4.9) and erysipelas on abdomen or legs at least once during the past 6 months (RR 3.6). Survivors treated with radiation therapy alone showed in general higher rates of symptoms.</p></sec><sec><title>Conclusion:</title><p>Gynaecological cancer survivors previously treated with pelvic radiation report a higher occurrence of symptoms from the urinary and gastrointestinal tract as well as lymph oedema, sexual dysfunction and pelvic pain compared with non-irradiated control women. Health-care providers need to actively ask patients about specific symptoms in order to provide proper diagnostic investigations and management.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Al Abany, M" uniqKey="Al Abany M">M al-Abany</name></author><author><name sortKey="Helgason, Ar" uniqKey="Helgason A">AR Helgason</name></author><author><name sortKey="Cronqvist, Ak" uniqKey="Cronqvist A">AK Cronqvist</name></author><author><name sortKey="Lind, B" uniqKey="Lind B">B Lind</name></author><author><name sortKey="Mavroidis, P" uniqKey="Mavroidis P">P Mavroidis</name></author><author><name sortKey="Wers Ll, P" uniqKey="Wers Ll P">P Wersäll</name></author><author><name sortKey="Lind, H" uniqKey="Lind H">H Lind</name></author><author><name sortKey="Qvanta, E" uniqKey="Qvanta E">E Qvanta</name></author><author><name sortKey="Steineck, G" uniqKey="Steineck G">G 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Nyberg</name><name sortKey="Olsson, C" sort="Olsson, C" uniqKey="Olsson C" first="C" last="Olsson">C. Olsson</name><name sortKey="Olsson, C" sort="Olsson, C" uniqKey="Olsson C" first="C" last="Olsson">C. Olsson</name><name sortKey="Steineck, G" sort="Steineck, G" uniqKey="Steineck G" first="G" last="Steineck">G. Steineck</name><name sortKey="Steineck, G" sort="Steineck, G" uniqKey="Steineck G" first="G" last="Steineck">G. Steineck</name><name sortKey="Waldenstrom, A C" sort="Waldenstrom, A C" uniqKey="Waldenstrom A" first="A-C" last="Waldenström">A-C Waldenström</name><name sortKey="Waldenstrom, A C" sort="Waldenstrom, A C" uniqKey="Waldenstrom A" first="A-C" last="Waldenström">A-C Waldenström</name><name sortKey="Wilder Ng, U" sort="Wilder Ng, U" uniqKey="Wilder Ng U" first="U" last="Wilder Ng">U. Wilder Ng</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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