Abstract
PURPOSE: This systematic review aimed to identify and compare tools used to evaluate quality of life (QoL) after pelvic radiation for cervical cancer and to describe variations in results within commonly used instruments. This review hypothesized regional preferences in the selection of these tools and an absence of uniformity in their application globally. METHODS AND MATERIALS: A comprehensive search of 6 databases was conducted between the inception of each included database and June 14, 2023, focusing on studies evaluating the QoL of patients with cervical cancer during and after radiation. Excluded were studies involving cancers originating outside the cervix, those not exclusively undergoing radiation or chemoradiation therapy, such as patients who have undergone surgery, and non-English studies. RESULTS: Ultimately, 229 studies covering 25,693 patients and 51 countries were identified. Most studies were conducted in Asia (35.6%) and Europe (32.9%). Ninety-nine QoL instruments were identified, not including those that were specific to a single study. The European Organisation for Research and Treatment of Cancer QoL Questionnaire Core 30 (20.5%) and the European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaire cervical cancer module (16.0%) were the most commonly used; however, US-based studies primarily used the Functional Assessment of Cancer Therapy-General surveys. Furthermore, there was significant variability in the timelines of survey usage in relation to when treatment was completed, further limiting the comparisons that can be made. Of the 127 studies that reported data on the time points after completion of treatment at which QoL was measured, 72.4% measured QoL within 1 year of treatment completion, and 48.8% measured QoL >1 year after treatment completion, with some studies using multiple time points for their research. CONCLUSIONS: This study revealed a fragmented landscape with significant variability in QoL survey use, limiting the generalizability and usefulness of these results to drive meaningful change. There is a need for a global standardized method to evaluate QoL after treatment of cervical cancer with radiation therapy for comparison across regions. Simplified tools may assist with the broader collection of data, which may lead to advancements for improvement of the QoL of these patients.