rehabРеабилитологияJournal of Medical Rehabilitation2949-58732949-5881IRBIS Publishing House (IRBIS LLC)10.17749/2949-5873/rehabil.2026.81rehab-168Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESДинамика качества жизни у получающих реабилитацию пациенток с раком шейки матки: проспективное когортное исследованиеChanges in quality of life among patients with cervical cancer undergoing rehabilitation: a prospective cohort studyhttps://orcid.org/0009-0006-2166-2574АкавоваС. А.AkavovaS. A.Акавова Саида АбдулкадыровнаЗагородное ш., д. 18А, стр. 7, Москва 117152

Saida A. Akavova

18А bldg 7 Zagorodnoe Shosse, Moscow 117152

https://orcid.org/0000-0003-1115-3144ИвановА. Е.IvanovA. E.Иванов Александр Евгеньевич , к.м.н.Загородное ш., д. 18А, стр. 7, Москва 117152

Aleksandr E. Ivanov , PhD

18А bldg 7 Zagorodnoe Shosse, Moscow 117152

https://orcid.org/0009-0002-7356-9698БулгаковаС. В.BulgakovaS. V.Булгакова Светлана Владимировна , к.м.н.Загородное ш., д. 18А, стр. 7, Москва 117152

Svetlana V. Bulgakova , PhD

18А bldg 7 Zagorodnoe Shosse, Moscow 117152

Филиал «Онкологический центр № 1 Городской клинической больницы им. С.С. Юдина Департамента здравоохранения г. Москвы»РоссияOncology Center No. 1 branch of Yudin City Clinical HospitalRussian FederationФилиал «Онкологический центр № 1 Городской клинической больницы им. С.С. Юдина Департамента здравоохранения г. Москвы»; Общество с ограниченной ответственностью «АМЕДИУС» (Шуваловская клиника)РоссияOncology Center No. 1 branch of Yudin City Clinical HospitalRussian Federation20261608202642103–116Copyright © Акавова С.А., Иванов А.Е., Булгакова С.В., 20262026Акавова С.А., Иванов А.Е., Булгакова С.В.Akavova S.A., Ivanov A.E., Bulgakova S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rehabilitology.com/jour/article/view/168Актуальность

Актуальность. Рак шейки матки (РШМ) остается значимой проблемой онкогинекологии, занимая ведущие позиции в структуре заболеваемости женщин. Применяемые методы лечения оказывают существенное влияние на качество жизни (КЖ) пациенток. Данных о динамике КЖ в процессе реабилитации пациенток с РШМ разных стадий недостаточно.

Цель

Цель: проанализировать динамику КЖ в реабилитационном периоде у пациенток с РШМ, получавших лечение различными методами, в течение 3-летнего периода наблюдения с использованием опросника для общей функциональной оценки противоопухолевой терапии (англ. Functional Assessment of Cancer Therapy General, FACT-G) с расширением для РШМ.

Материал и методы

Материал и методы. Проведено проспективное когортное исследование с участием 302 пациенток с верифицированным РШМ, распределенных на четыре группы в зависимости от стадии и метода лечения (от конизации при раке in situ до химиолучевой терапии при III стадии) и контрольную группу (n=43). Программа реабилитации интегрировала пререабилитацию и последующую реабилитацию, сочетая медикаментозные, немедикаментозные и психотерапевтические подходы. КЖ оценивали до начала лечения, через 1 нед, 1 мес, 3 мес, 6 мес, 12 мес, 2 года и 3 года.

Результаты

Результаты. До лечения все группы пациенток с РШМ имели достоверно более низкие показатели КЖ по сравнению с контролем (общий балл FACT-G от 78,3±6,1 в 0-й группе до 54,2±7,2 в 3-й группе против 97,5±5,4 в контроле; p<0,05). Динамика КЖ носила двухфазный характер: острое снижение в раннем периоде (1 нед 1 мес) с последующим постепенным восстановлением. Наиболее быстрое и полное восстановление до уровня контрольной группы наблюдалось у пациенток с ранними стадиями (0-я группа) к 6-му месяцу. В 3-й группе (химиолучевая терапия) восстановление было самым медленным и неполным: через 3 года общий балл FACT-G (82,3±6,3) оставался значимо ниже контрольных значений (p<0,05). Наибольшие нарушения отмечались в доменах «физическое состояние» и «эмоциональное благополучие».

Заключение

Заключение. Динамика КЖ в реабилитационном периоде зависит от метода и объема лечения РШМ. Пациентки после органосохраняющих операций имеют наиболее благоприятный прогноз восстановления. Самая тяжелая и длительная реабилитация требуется больным после химиолучевой терапии. Полученные данные могут служить основой для разработки персонализированных программ реабилитации.

Background

Background. Cervical cancer (CC) remains a significant problem in gynecologic oncology, occupying leading positions in the morbidity structure among women. Current treatment methods have a substantial impact on the quality of life (QoL) of patients. However, data on the dynamics of QoL during the rehabilitation process in patients with CC across different stages are insufficient. Objective: To analyze the QoL dynamics during the rehabilitation period in CC patients who received various treatment modalities over a 3-year follow-up period, using the Functional Assessment of Cancer Therapy General (FACT-G) questionnaire with extension for CC.

Material and methods

Material and methods. A prospective cohort study was conducted involving 302 patients with verified CC. The participants were divided into four groups in accordance with disease stage and treatment modality, ranging from conization for carcinoma in situ to chemoradiotherapy for stage III, and a control group (n=43). The rehabilitation program integrated prehabilitation and subsequent rehabilitation, combining pharmacological, non-pharmacological, and psychotherapeutic approaches. QoL was assessed before treatment, at 1 week, 1, 3, 6, 12 months, 2 and 3 years.

Results

Results. Before treatment, all groups of CC patients had significantly lower QoL scores compared to the control group (total FACT-G score: from 78.3±6.1 in Group 0 to 54.2±7.2 in Group 3 vs. 97.5±5.4 in the control group; p<0.05). The dynamics of QoL were biphasic: an acute decline in the early period (1 week 1 month) followed by gradual recovery. Patients with early-stage disease (Group 0) showed the fastest and most complete recovery to the control group’s level by the 6[th] month. In Group 3 (chemoradiotherapy), recovery was the slowest and most incomplete: at 3 years, the total FACT-G score (82.3±6.3) remained significantly below control values (p<0.05). The greatest impairments were observed in “physical well-being” and “emotional well-being” domains.

Conclusion

Conclusion. The QoL during the rehabilitation period fluctuates due to treatment modality and therapy extent. While patients after fertility-sparing surgeries have the most favorable prognosis for recovery, patients after chemoradiotherapy require the most intense and prolonged rehabilitation. The obtained data can be used to develop personalized rehabilitation programs.

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The authors declare that there are no conflicts of interest present.