The Influence of Treatment Modalities on Quality of Life, Survival, and Cost-Effectiveness for Stage IB2 and IIA Cervical Squamous Cell Carcinoma in Taiwan

Surgery is still the primary treatment for stage IB2 and IIA cervical cancer; however, cervical squamous cell carcinoma has high radiosensitivity. Previous studies have indicated that there were no differences of the length of survival between the surgery and radiotherapy groups. Therefore, the major purposes of the study are to explore (1) the differences of quality of life (QoL) between women who have had surgery and chemoradiation and those who have had chemoradiation, (2) the effect of self-esteem and social support on QoL, (3) the length of survival in the two different treatment modalities, and (4) the cost-effectiveness of the two treatment modalities. In the first year, 151 patients who had surgery with chemoradiation and 151 patients who had only chemoradiation for stage IB2 or IIA cervical squamous cell carcinoma will be recruited according to the power analysis. The instruments include the QoL scales (EQ- 5D, EORTC QLQ-C30, and -CX24), Rosenberg Self-Esteem scale, and Medical Outcome Study Social Support Survey. The ANCOVA, Hierarchical Multiple Linear Regression, path analysis, and Sobel test will be used to analyze the data. In the second year, the data from the EQ-5D, combined with the data from the Taiwan Registry, Department of Health, and Bureau of National Health Insurance will be utilized to explore the differences in survival time and cost- effectiveness in the two treatment modalities. Survival estimates will be generated using Kaplan- Meier method and differences between the two treatments will be tested using log-rank testing. In addition, incremental cost-effectiveness ratio with quality-adjusted life years will be used to calculate the cost-effectiveness. The results of the study will provide health-care providers and patients information for making treatment decisions and improving health-related outcomes.

Project ID:PC10301-0562
External Project ID:NSC102-2314-B182-004-MY2