FEBE: The female brachytherapy experience. Assessing PTSD symptom rates in women treated for locally advanced cervical cancer with HDR brachytherapy.

PURPOSE: Management of gynecologic brachytherapy (BT) procedural pain or discomfort varies across institutions. We sought to determine the prevalence of post-BT post-traumatic stress disorder (PTSD) symptoms among locally advanced cervical cancer (LACC) patients and assess differences based on type of analgesia.

METHODS AND MATERIALS: We queried an IRB-approved institutional database for women at one high-volume academic medical center who received high-dose-rate (HDR)-BT for LACC between January 1, 2015 and September 30, 2021. Enrolled patients completed two validated questionnaires by phone: (1) Impact of Event Scale-Revised (IES-R), and (2) European Organization for Research and Treatment of Cancer Quality of Life Group Core Questionnaire-Cervical Cancer Module (EORTC QLQ-CX24). Optional open commentary was offered.

RESULTS

Of 56 eligible patients, 21 patients aged 30-69 years were enrolled; 17 were treated for intact LACC and 4 were treated postoperatively. FIGO stage ranged from 1B1-IVA. Five Black/African American, 6 Hispanic, 2 Asian, 14 unknown race, and 9 unknown ethnicity patients were included. Mean time since treatment was 3.27 years (1.5-6 years). The mean IES-R score was 16.62 (0-73). Three women scored >32, indicating probable PTSD symptoms. Three scored between 24 and 32, suggesting partial PTSD symptoms. Six scored <24, equating to a partial to full PTSD symptom rate of 28.6% (95% CI: 11.3%, 52.2%). Small sample size precluded analyses of associations between AS technique and PTSD symptoms.

CONCLUSION

Partial to full PTSD symptoms were present in 28.6% of women treated with HDR-BT for LACC in a population largely receiving BT without sedation. Further prospective study into associations between HDR-BT AS practices and PTSD symptoms is warranted.