Co-occurrence of symptoms after radiochemotherapy in locally advanced cervix cancer patients: a cluster analysis

Figures & data

Table 1. Patient-, disease- and treatment-related characteristics in the cohort eligible for analysis. Abbreviations: BMI:body mass index; EBRT VXGy: volume treated with X Gy external beam radiotherapy dose; HDR: high dose rate; PDR: pulsed dose rate; IC: intracavitary; IC/is: intracavitary/interstitial.

	Included pat n = 742			Excluded pat n = 637
	Parameters	Values	Percentage	Values	Percentage
Age (years)	Median	48		51
	Min	22		21
	Max	83		92
BMI	NA	0	0%	19	3%
	Underweight (<18.5)	39	5%	26	4%
	Normal (18.5–24.9)	344	47%	265	42%
	Overweight (25–29.9)	216	29%	177	28%
	Obese (30+)	136	19%	143	22%
Smoking status	NA	25	3%	49	8%
	No	494	67%	396	62%
	Yes	223	30%	192	30%
WHO performance status	PS0	563	76%	422	68%
	PS1	167	23%	180	29%
	PS2	10	1%	22	4%
	PS3	2	<1%	1	<1%
Comorbidities	NA	0	0%	12	2%
	No	541	73%	433	68%
	Yes	201	27%	192	30%
FIGO 2009 stage	IB	130	17%	119	19%
	IIA	29	4%	40	6%
	IIB	421	57%	287	45%
	IIIA	5	1%	8	1%
	IIIB	96	13%	99	16%
	IVA	14	2%	21	3%
	IVB	47	6%	51	8%
Chemotherapy	NA	0	0%	31	5%
	No	32	4%	41	6%
	Cisplatin	696	94%	541	85%
	Other	13	2%	24	4%
	of which reduced cycle	8	61%	13	54%
EBRT prescribed dose	NA	0	0%	33	5%
	<47.5 Gy	594	80%	446	70%
	>47.5 Gy	148	20%	158	25%
EBRT technique	3D-CRT	472	64%	322	53%
	IMRT/VMAT	270	36%	281	47%
EBRT lymph node boost	No	478	64%	391	65%
	Yes	264	36%	214	35%
Para-aortic irradiation	NA	0	0%	32	5%
	No	637	86%	492	77%
	Yes	105	14%	113	18%
Brachytherapy dose rate	HDR	429	58%	336	57%
	PDR	313	42%	258	43%
Brachytherapy technique	IC	503	68%	370	62%
at $1^{st}$ fraction	IC/IS	239	32%	224	38%

Figure 1. Correlation values between the occurrence of the symptoms in the EORTC data (on the left) and in the CTCAE data (on the right). The red colour indicates positive correlation with darker shades representing higher correlation.

Figure 2. Factor analysis results for the EORTC data (on the top) and the CTCAE data (on the bottom). Each vertical box represents one of the symptoms clusters identified by factor analysis. The length of bars indicates the loadings (weights) on the symptoms.

Table 2. Regression coefficients and standard deviations for the association between QOL and the estimated clusters of symptoms in the EORTC and CTCAE data sets. Significance levels are reported after multiple testing correction. *** significant at p < 0.001, ** significant at p < 0.01, and * significant at p < 0.05.

		General symptoms	Gastro-intestinal	Urinary	Vaginal	Nausea
EORTC	3M	−12.64 (1.01) ***	−2.36 (0.99) *	1.06 (0.94)	0.77 (1.01)	−1.61 (0.97)
	6 M	−14.11 (0.94) ***	−1.15 (0.85)	1.92 (0.91)	0.49 (0.88)	−3.45 (0.9) ***
	9 M	−14.77 (1.04) ***	−2.96 (1.07) **	2.86 (0.93) **	−0.89 (1.10)	−3.33 (0.88) ***
	12 M	−15.77 (1.02) ***	−1.54 (1.02)	1.44 (1.06)	−0.18 (1.19)	−0.35 (1.02)
	18 M	−15.17 (0.91) ***	−0.32 (0.91)	−0.28 (1.01)	−0.16 (0.98)	−4.9 (0.83) ***
	24 M	−16.21 (0.98) ***	−0.70 (0.88)	1.24 (0.93)	−1.19 (0.96)	−1.31 (0.89)
CTCAE	3M	−6.95 (1.23) ***	−1.22 (1.12)	1.17 (1.01)	0.61 (1.09)	–
	6 M	−10.56 (1.09) ***	−1.34 (1.12)	−0.33 (1.24)	0.78 (1.17)	–
	9 M	−7.89 (1.17) ***	−2.9 (1.12) *	−3.24 (1.29)	−0.31 (1.31)	–
	12 M	−10.93 (1.10) ***	−1.91 (1.05)	−0.69 (1.27)	0.99 (1.06)	–
	18 M	−12.42 (1.15) ***	−3.09 (1.30) *	−0.15 (1.08)	2.61 (1.13)	–
	24 M	−11.10 (1.11) ***	−2.76 (1.11) *	0.19 (1.22)	0.58 (1.24)	–