Background: Different strategies have been proposed for the treatment of locally advanced cervical cancer (LACC), with different impacts on patient’s quality of life (QoL). This study aimed to analyze urinary, bowel, and sexual dysfunctions in a series of LACC patients who underwent chemotherapy, radiotherapy, radical surgery, or a combination of these treatments. Methods: Patients with LACC who underwent neoadjuvant radio–chemotherapy (NART/CT;n= 35), neoadjuvant chemotherapy (NACT;n= 17), exclusive radio–chemotherapy (ERT/CT;n= 28), or upfront surgery (UPS;n= 10) from November 2010 to September 2019 were identified from five oncological referral centers. A customized questionnaire was used for the valuation of urinary, gastrointestinal, and sexual dysfunctions. Results: A total of 90 patients were included. Increased urinary frequency (>8 times/day) was higher in ERT/CT compared with NACT/RT (57.1% vs. 28.6%;p= 0.02) and NACT (57.1% vs. 17.6%;p= 0.01). The use of sanitary pads for urinary leakage was higher in ERT/CT compared with NACT/RT (42.9% vs. 14.3%;p= 0.01) and NACT (42.9% vs. 11.8%;p= 0.03). The rate of reduced evacuations (<3 times a week) was less in UPS compared with NACT/RT (50% vs. 97.1%;p< 0.01), NACT (50% vs. 88.2,p< 0.01), and ERT/CT (50% vs. 96.4%;p< 0.01). A total of 52 women were not sexually active after therapy, and pain was the principal reason for the avoidance of sexual activity. Conclusions: The rate and severity of urinary, gastrointestinal, and sexual dysfunction were similar in the four groups of treatment. Nevertheless, ERT/CT was associated with worse sexual and urinary outcomes.
背景：针对局部晚期宫颈癌（LACC）的治疗已提出多种策略，这些策略对患者生活质量（QoL）的影响各不相同。本研究旨在分析接受化疗、放疗、根治性手术或联合治疗的LACC患者群体中泌尿、肠道及性功能障碍的发生情况。方法：研究纳入2010年11月至2019年9月期间在五家肿瘤转诊中心接受新辅助放化疗（NART/CT；n=35）、新辅助化疗（NACT；n=17）、单纯放化疗（ERT/CT；n=28）或直接手术（UPS；n=10）的LACC患者。采用定制问卷评估泌尿、胃肠道及性功能障碍。结果：共纳入90例患者。与NART/CT组（57.1% vs. 28.6%；p=0.02）和NACT组（57.1% vs. 17.6%；p=0.01）相比，ERT/CT组尿频（>8次/天）发生率更高。在尿失禁需使用卫生护垫方面，ERT/CT组发生率高于NART/CT组（42.9% vs. 14.3%；p=0.01）和NACT组（42.9% vs. 11.8%；p=0.03）。与NART/CT组（50% vs. 97.1%；p<0.01）、NACT组（50% vs. 88.2%；p<0.01）及ERT/CT组（50% vs. 96.4%；p<0.01）相比，UPS组排便减少（<3次/周）发生率最低。治疗后共有52例女性未恢复性生活，疼痛是回避性活动的主要原因。结论：四种治疗方式的泌尿、胃肠道及性功能障碍发生率和严重程度总体相近，但ERT/CT治疗与更严重的性功能及泌尿系统不良结局相关。
肿瘤(癌症)患者之家