In Belgium, 600 women are yearly diagnosed with cervical cancer
(CX), with a peak around 45 years (sexually active at the time of
diagnosis). Treatment of limited CX consists of surgery, completed
by chemo-radiotherapy (C-RT) in case of high-risk of relapse.
Inoperable, locally advanced tumors are treated by C-RT and
brachytherapy. The 3-year local control is 73% to 94%. To increase
this, we have been treating patients with locally advanced CX since
2005 with intensity modulated arc-RT (IMAT) with concomitant
chemotherapy (IMAT-C), followed by surgery. IMAT allows a higher
radiation dose on the tumor and a lower dose on the healthy organs
and environment. This allows us to omit brachytherapy and perform
surgery. Doing this, we achieve good local control and survival. If
there is a choice between treatments, in addition to survival data,
toxicity profiles must also be taken into account. Since recent, there
is (limited) attention for sexual functioning. In this project we want to
investigate the vaginal symptoms, sexual functioning and quality of
life of the IMAT-C + surgery strategy against the treatment in which
surgery was initially applied. For this we will combine both the vaginal
morbidity (physicians reports) and the patient-reported findings on
vaginal symptoms, sexual functioning and quality of life. Hypothesis:
IMAT-C followed by surgery leads to fewer vaginal symptoms and
sexual dysfunction than conventional treatment.