Quality of life outcomes following hypofractionated radiotherapy in locally advanced cervical cancer.

5534 Background: Cervical cancer remains a significant global health burden, particularly in low- and middle-income countries where access to radiotherapy is often limited. While concurrent chemoradiotherapy is the standard of care, hypofractionated radiotherapy has emerged as a potential strategy to improve treatment efficiency without compromising outcomes. Our purpose was to assess the impact of hypofractionated radiotherapy on quality of life in comparison with conventional fractionation in patients with locally advanced cervical cancer. Methods: Health-related quality of life was evaluated using EORTC QLQ-C30 and QLQ-CX24 questionnaires in patients with FIGO stage IB3–IIIC1 cervical cancer enrolled in a phase II randomized trial. All patients received concurrent chemotherapy and were assigned to either standard external-beam radiotherapy (50 Gy in 25 fractions) or hypofractionated radiotherapy (37.5 Gy in 15 fractions), followed by radical hysterectomy with bilateral pelvic lymphadenectomy. QoL scores were calculated using standard EORTC methodology. Higher scores indicate better functioning or greater symptom burden, and changes were interpreted based on established thresholds for clinical relevance. Outcomes were compared between groups across predefined time points using ANOVA. Statistical significance was defined as p < 0.05. Results: A total of 91 patients were included (49 standard fractionation, 42 hypofractionation). No significant differences in global QoL were observed between treatment groups. However, QoL varied significantly over time, with the greatest deterioration occurring between completion of concomitant chemoradiotherapy and surgery. Quality-of-life scores recovered to baseline levels by three months after treatment completion in both groups. Conclusions: Hypofractionated radiotherapy was not associated with worse quality-of-life outcomes compared with conventional fractionation. These findings support hypofractionation as a feasible alternative for locally advanced cervical cancer, particularly in resource-limited settings. Further studies with larger cohorts and longer follow-up are warranted to confirm these results. Clinical trial information: NCT03750539 . Comparison of key health-related quality-of-life domains by treatment arm. Domain BaselineStd*/ Hypo& End QT/RTStd / Hypo Post-SurgeryStd / Hypo 3 MonthsStd / Hypo p value Global Health Status / QoL 66.9 (23.7) / 65.8 (21.0) 65.7 (20.7) / 64.6 (17.0) 70.5 (18.5) / 64.0 (18.3) 79.1 (12.5) / 74.4 (21.7) 0.497 Physical Functioning 81.6 (19.7) / 88.0 (14.6) 80.2 (18.6) / 82.2 (20.8) 75.2 (20.5) / 79.0 (17.5) 86.4 (19.4) / 86.8 (13.6) 0.216 Nausea and Vomiting 87.1 (21.2) / 83.8 (27.8) 72.4 (30.5) / 67.2 (28.5) 82.6 (23.3) / 88.3 (21.0) 94.8 (10.2) / 91.1 (16.8) 0.001 Diarrhea 90.1 (15.5) / 86.6 (28.5) 77.7 (20.6) / 67.7 (28.3) 81.4 (21.3) / 84.4 (25.8) 92.5 (14.1) / 91.1 (14.9) 0.001 Mean (SD) scores using EORTC QLQ-C30 and CX-24.