KEY POINTS
- This exploratory single-centre survivorship study contacted 56 eligible women previously treated with HDR brachytherapy for cervical cancer; only 21 participated, including 17 with intact disease and four treated postoperatively.
- Patients completed the validated Impact of Event Scale-Revised (IES-R) and EORTC QLQ-CX24 by telephone at a mean 3.27 years after treatment, making the results primarily a measure of persistent survivorship symptoms rather than acute procedural distress.
- Institutional HDR practice included intracavitary, hybrid and interstitial techniques. Among the 17 patients with an intact cervix, 71% received oral narcotics/anxiolytics alone, 12% conscious sedation and 18% general anesthesia.
- Mean IES-R score was 16.62. Three women met the screening threshold for probable PTSD and another three for probable partial PTSD, producing a combined symptom rate of 28.6%.
- IES-R is a screening tool rather than a diagnostic assessment, so the study documents PTSD symptom burden rather than confirmed clinical PTSD diagnoses.
- Persistent quality-of-life concerns were also evident. Mean EORTC QLQ-CX24 scores were 31.68 for body-image symptoms, 34.92 for sexual worry and 45.37 for sexual/vaginal-function symptoms.
- The study cannot determine whether anesthesia strategy influences PTSD symptoms. The cohort was too small for subgroup analysis, only 21 of 56 eligible women participated, assessment occurred years after treatment, and the psychological impact of the cancer diagnosis and other therapies cannot be separated from the brachytherapy experience itself.
CLINICAL TAKEAWAY
Gynecologic brachytherapy is an essential curative treatment, but its procedural experience may leave a psychological burden that persists into survivorship. These data support proactively discussing pain, anxiety and procedural expectations and asking about psychological distress afterward, while larger prospective studies are needed before linking PTSD symptoms to any specific anesthesia or analgesia approach.