Impact of Chemoradiotherapy on Pelvic Floor Function and Quality of Life in Women with Cervical Cancer

Abstract

Objective: Cervical cancer remains a leading cause of morbidity and mortality among women in low- and middle-income countries. While chemoradiotherapy (CRT) improves survival, it frequently results in long-term pelvic floor dysfunction (PFD) and impaired quality of life (QoL), which are often underreported in routine oncology care. This study therefore sought to assess the impact of CRT on pelvic floor function and QoL in women with cervical cancer in Tripura, India.

Methods: We conducted a prospective observational study involving 384 women with histologically confirmed cervical cancer (FIGO stages IB2–IVA), treated at the Atal Bihari Vajpayee Regional Cancer Centre, Agartala, between 2022 and 2024. Standardized and validated questionnaires, including the Pelvic Floor Distress Inventory (PFDI-20), Overactive Bladder Symptom Score (OABSS), and EuroQol-5 Dimension (EQ-5D), were administered. Associations between clinical variables and symptom prevalence were examined using chi- square tests and logistic regression analysis.

Results: Most frequently reported complications were constipation, urinary frequency, and stress urinary incontinence. Women with higher body mass index (BMI) and those who received multimodal therapy, particularly surgery combined with radiotherapy, exhibited significantly higher rates of urinary and bowel symptoms. Parity ≤2 was associated with reduced symptom prevalence. No significant associations were observed between parity and PFD scores or between FIGO stage and PFF outcomes.

Conclusion: CRT substantially impairs pelvic floor function and QoL in women with cervical cancer. with obesity and combined treatment modalities emerging as important contributors to long-term morbidity. These findings underscore the need for patient-tailored management strategies, including BMI optimization, precise radiotherapy planning, and the integration of early pelvic rehabilitation programs, to mitigate chronic pelvic dysfunction and preserve QoL in this vulnerable population.