Fatigue, insomnia and hot flashes after definitive radiochemotherapy and image-guided adaptive brachytherapy for locally advanced cervical cancer: An analysis from the EMBRACE study

EMBRACE Collaborative Group

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To evaluate the pattern of manifestation of fatigue, insomnia and hot flashes within the prospective, observational, multi-center EMBRACE study.

METHODS: Morbidity was prospectively assessed according to CTCAE v.3 and patient-reported outcome with EORTC QLQ-C30/CX24 at baseline and regular follow-up. Analyses of crude incidence, prevalence rates and actuarial estimates were performed.

RESULTS: A total of 1176 patients were analyzed with a median follow-up of 27 months. At baseline, CTCAE G1/G2 prevalence rates for fatigue were 29%/6.2%, for insomnia 18%/3.1% and for hot flashes 7.9%/1.6% with respective 3-year prevalence rates of 29%/6.8%, 17%/4.4% and 19%/5.9%. Similar patterns of manifestation were seen in patient-reported EORTC outcomes. The 3-year actuarial estimates for G ≥ 3 CTCAE fatigue, insomnia and hot flashes were 5.5%, 4.7% and 1.9%. Younger age was associated with significantly higher risk for fatigue, insomnia and hot flashes.

CONCLUSION: Fatigue, insomnia and hot flashes occurred mainly in the mild to moderate range. Fatigue and insomnia were already present before treatment and showed minor fluctuations or recovery during follow-up, whereas hot flashes showed a considerable increase after treatment. More research is needed to evaluate contributing risk factors in order to define intervention strategies.

Original languageEnglish
Pages (from-to)440-448
Number of pages9
JournalRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Volume127
Issue number3
Early online date5 Apr 2018
DOIs
Publication statusPublished - Jun 2018

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Brachytherapy/adverse effects
  • Chemoradiotherapy/adverse effects
  • Cisplatin/adverse effects
  • Fatigue/etiology
  • Female
  • Hot Flashes/etiology
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Prospective Studies
  • Radiation Injuries/chemically induced
  • Radiotherapy, Image-Guided/adverse effects
  • Sleep Initiation and Maintenance Disorders/etiology
  • Uterine Cervical Neoplasms/diagnostic imaging
  • Young Adult

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre

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