Quality of Life Better Following Brachytherapy Than External Beam Radiation Therapy for Endometrial Cancer

Women treated with brachytherapy for endometrial cancer reported a significantly better quality of life compared to patients who underwent external beam radiation therapy (EBRT) in a recent European study.

The Post Operative Radiation Therapy in Endometrial Cancer (PORTEC) trial conducted by Remi A. Nout, et al, measured quality of life based on lower role functioning, diarrhea and fatigue. The article, “Quality of Life After Pelvic Radiotherapy or Vaginal Brachytherapy for Endometrial Cancer: First Results of the Randomized PORTEC-2 Trial,” was published in the July 20, 2009, Journal of Clinical Oncology.

Of the 427 patients in the study, 214 were randomly assigned to EBRT and 213 to vaginal brachytherapy (VBT). The study assessed quality of life at a median follow-up of two years.

Patient functioning was lowest at baseline after surgery and increased during and after EBRT, with a plateau at 12 months, the authors reported. The patients who received VBT reported better social functioning and lower symptom scores for diarrhea, fecal leakage, the need to stay close to a bathroom and limitation in daily activities due to bowel symptoms.

Fifteen percent of the study participants in both groups were sexually active at baseline. That percentage increased to 39 percent during the first year, according to the researchers.

“Patients who received EBRT reported significantly higher levels of diarrhea and bowel symptoms,” the authors concluded. “This resulted in a higher need to remain close to a toilet and, as a consequence, more limitation of daily activities because of bowel symptoms and decreased social functioning. Vaginal brachytherapy provides a better quality of life, and should be the preferred treatment from a quality of life perspective.”