Changes in physical function in older women with endometrial cancer with or without adjuvant therapy

Allison M Quick; Eric McLaughlin; Jessica L Krok Schoen; Ashley S Felix; Carolyn J Presley; Elizabeth M Cespedes Feliciano; Aladdin H Shadyab; Su Yon Jung; Juhua Luo; Jennifer J King; Stephen R Rapp; Samantha Werts; Rowan T Chlebowski; Michelle Naughton; Electra Paskett

doi:10.1007/s11764-023-01460-8

Changes in physical function in older women with endometrial cancer with or without adjuvant therapy

J Cancer Surviv. 2023 Sep 5. doi: 10.1007/s11764-023-01460-8. Online ahead of print.

Authors

Allison M Quick¹, Eric McLaughlin², Jessica L Krok Schoen^{3

4}, Ashley S Felix⁵, Carolyn J Presley⁴, Elizabeth M Cespedes Feliciano⁶, Aladdin H Shadyab⁷, Su Yon Jung⁸, Juhua Luo⁹, Jennifer J King¹⁰, Stephen R Rapp¹¹, Samantha Werts¹², Rowan T Chlebowski¹³, Michelle Naughton¹⁴, Electra Paskett^{5

14}

Affiliations

¹ Department of Radiation Oncology, The Ohio State University Medical Center, Columbus, OH, USA. allison.quick@osumc.edu.
² Center for Biostatistics, The Ohio State University, The Ohio State University, Columbus, OH, USA.
³ Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.
⁴ Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.
⁵ Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA.
⁶ Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
⁷ Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA.
⁸ Translational Sciences Section, School of Nursing, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA.
⁹ Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA.
¹⁰ University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA.
¹¹ Department of Psychiatry & Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
¹² Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
¹³ The Lundquist Institute, Torrance, CA, USA.
¹⁴ Comprehensive Cancer Center, Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.

PMID: 37668940
DOI: 10.1007/s11764-023-01460-8

Abstract

Objective: To evaluate changes in physical function (PF) for older women with endometrial cancer (EC) + / - adjuvant therapy in the Women's Health Initiative Life and Longevity after Cancer cohort.

Materials and methods: This study examined women ≥ 70 years of age with EC with available treatment records. Change in PF was measured using the RAND-36 and compared between groups using Wilcoxon rank-sum tests. Multivariable median regression was used to compare the changes in scores while adjusting for confounding variables.

Results: Included in the study were 287 women, 150 (52.3%) women who did not receive adjuvant therapy and 137 (47.7%) who received adjuvant therapy. When comparing PF scores, there was a statistically significant difference in the median percent change in functional decline, with a greater decline in those who received adjuvant therapy (- 5.9% [- 23.5 to 0%]) compared to those who did not (0 [- 18.8 to + 6.7%]), p = 0.02). Results were not statistically significant after multivariable adjustment, but women who underwent chemotherapy had a greater percent change (median ∆ - 13.8% [- 35.5 to 0%]) compared to those who received radiation alone (median ∆ - 5.9% [- 31.3 to 0%]) or chemotherapy and radiation (median ∆ - 6.5% [- 25.8 to + 5.7%].

Conclusions: Older women with EC who received adjuvant therapy experienced greater change in PF than those who did not receive adjuvant therapy, particularly women who received chemotherapy. These results were not statistically significant on multivariate analysis.

Implications for cancer survivors: EC survivors may experience changes in PF because of chemotherapy and/or radiation therapy. Additional supportive care may need to be provided to older women to mitigate functional decline.

Keywords: Adjuvant therapy; Chemotherapy; Endometrial cancer; External beam radiation; Functional decline; Functional status; LILAC; Older women; RAND-36; Radiation; Vaginal brachytherapy; WHI; Women’s Health Initiative.

Grants and funding

1K76AG074923-01/NH/NIH HHS/United States