LB72
Psychological effects of treatment toxicity in gynaecological cancer patients: a longitudinal study
Claire Barker, Jacqueline Routledge, Damian Farnell, Ric Swindell, Susan Davidson
The Christie NHS Foundation Trust, Manchester, UK
Background
Previous research has shown that late treatment effects have a negative
impact on quality of life (QoL) for at least 2 years following radiotherapy.1
The aims of this study were to investigate the impact of late treatment effects
on psychological health by use of the Hospital Anxiety Depression Scale (HADS)
and also the relationship between HADS scores and QoL.
Method
This was a prospective study involving 224 gynaecological cancer patients.
Patients completed HADS, Late Effects on Normal Tissue Subjective Objective
Management Analytic scales (LENT SOMA) and EORTC QLQ-C30 questionnaires both
pre- and post-treatment (immediately post-radiotherapy, 6 weeks, 12, 24 and 36
months).
Results
Late treatment effects were strongly correlated with HADS-A and HADS-D
scores [rs 0.267 to 0.652 for HADS-A, 0.364 to 0.623 for
HADS-D (all p values <.05)] at all time points both pre and
post-radiotherapy, and those patients with high levels of treatment toxicity
had increased HADS scores (all p values <.05, except HADS-A at 36
months). There was a strong negative correlation between QoL and both anxiety
and depression [rs -0.336 to -0.597 for HADS-A, -0.531 to
-0.782 for HADS-D (all p values <.05)].
Conclusion
Radiotherapy treatment for gynaecological cancer has a negative impact on psychological
health for at least 3 years following treatment. There is also a significant
relationship between both depression and anxiety and overall QoL. Effective
management strategies are needed to reduce late treatment effect symptoms and
improve patients QoL after treatment. Additionally an instrument such as HADS
should be used for the screening and detection of psychological morbidity in
oncology practice.
References
[1] Barker CL, Routledge JA, Farnell DJJ, Swindell R, Davidson SE. The
Impact of Radiotherapy Late Effects on Quality of Life in Gynaecological Cancer
Patients Br J Cancer 2009; 100: 1558-1565
