Summary
This study was conducted to assess long-term Quality of Life (QOL) in patients treated by radiotherapy with or without chemotherapy for anal carcinomas. Patients with a maximum age of 80 years, and who were alive at least 3 years following completion of treatment with a functioning anal sphincter and without active disease, were selected for this study. Of 52 such patients identified, 41 (79%) were evaluable. There were 35 females and six males with a median age of 71 years (55–80). The median follow-up interval was 116 months (range 37–218). QOL was assessed using two self-rating questionnaires developed by the European Organization for Research and Treatment of Cancer: one for cancer-specific QOL (EORTC QLQ-C30) and one for site-specific QOL (EORTC QLQ-CR38). For the function scales a higher score represents a higher level of functioning (100 being the best score), whereas for the symptom scales a higher score indicates a higher level of symptomatology/problems (0 being the best score). For the QLQ-C30, the functional scale scores ranged from 71 (global quality of life) to 85 (role function) and the symptom scale scores from 6 (nausea-vomiting) to 28 (diarrhoea). For the QLQ-CR38 module the functional scale scores ranged from 13 (sexual functioning) to 74 (body image) and for the symptom scale scores from 5 (weight loss) to 66 (sexual dysfunction in males). None of the functional and symptom scale scores seemed to be better in patients with longer follow-up. In patients treated with sphincter conservation for anal carcinomas, long-term QOL as measured by the EORTC QLQ-C30 and QLQ-CR38 appears to be acceptable, with the exception of diarrhoea and perhaps sexual function. Moreover, the subset of patients who presented with severe complications and/or anal dysfunction showed poorer scores in most scales.
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References
Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., Filiberti, A., Flechtner, H., Fleishman, S. B., de Haes, J. C., Kaasa, S., Klee, M., Osoba, D., Rozari, D., Rofe, P. B., Schraub, S., Sneeuw, K., Sullivan, M. & Takeda, F. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85: 365–376.
Allal, A., Kurtz, J. M., Pipard, G., Marti, M. C., Miralbell, R., Popowski, Y. & Egeli, R. (1993). Chemoradiotherapy versus radiotherapy alone for anal cancer: a retrospective comparison. Int J Radiat Oncol Biol Phys 27: 59–66.
Allal, A. S., Mermillod, B., Roth, A., Marti, M-C & Kurtz, J. (1997). Impact of clinical and therapeutic factors on major late complications after radiotherapy with or without concomitant chemotherapy for anal carcinoma. Int J Radiat Oncol Biol Phys 39: 1099–1105.
Andersen, B. L., Anderson, B. & deProsse, C. (1989). Controlled prospective longitudinal study of women with cancer: I. Sexual functioning outcomes. J Consult Clin Psychol 57: 683–691.
Anderson, B. & Lutgendorf, S. (1997). Quality of life in gynecologic cancer survivors. CA Cancer J Clin 47: 218–225
Anonymous (1996). Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. UKCCCR Anal Cancer Trial Working Party. UK Co-ordinating Committee on Cancer Research. Lancet 348: 1049–1054.
Bartelink, H., Roelofsen, F., Eschwege, F., Rougier, P., Bosset, J. F., Gonzalez, D. G., Peiffert, D., van Glabbeke, M. & Pierart, M. (1997). Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups. J Clin Oncol 15: 2040–2049.
Crook, J., Esche, B. & Futter, N. (1996). Effect of pelvic radiotherapy for prostate cancer on bowel, bladder, and sexual function: the patient’s perspective. Urology 47: 387–394.
Gelber, R. D., Goldhirsch, A., Cole, B. F., Wieand, H. S., Schroeder, G. & Krook, J. E. (1996). A quality-adjusted time without symptoms or toxicity (Q-TWiST) analysis of adjuvant radiation therapy and chemotherapy for resectable rectal cancer. J Natl Cancer Inst 88: 1039–1045.
Kapp, K. S., Stuecklschweiger, G. F., Kapp, D. S., Poschauko, J., Pickel, H. & Hackl, A. (1997). Carcinoma of the cervix: analysis of complications after primary external beam radiation and Ir-192 HDR brachytherapy. Radiother Oncol 42: 143–153.
Klee, M., Groenvold, M. & Machin, D. (1997). Quality of life of Danish women: population-based norms of the EORTC QLQ-C30. Qual Life Res 6: 27–34.
Minsky, B. D., Cohen, A. M., Enker, W. E. & Sigurdson, E. (1992). Phase I/II trial of pre-operative radiation therapy and coloanal anastomosis in distal invasive resectable rectal cancer. Int J Radiat Oncol Biol Phys 23: 387–392.
Nigro, N. D., Vaitkevicius, V. K. & Considine, B. (1974). Combined therapy for cancer of the anal canal. Dis Colon Rectum 27: 763–766.
Papillon, J. (1974). Radiation therapy in the managenent of epidermoid carcinoma of the anal region. Dis Colon Rectum 17: 181
Papillon, J., Monbarbon, J. F., Gérard, J. P., Chassard, J. L. & Ardiet, J. M. (1989). Interstitial curietherapy in the conservative treatment of anal and rectal cancers. Int J Radiat Oncol Biol Phys 17: 1161–1169.
Perez, C. A. & Brady, L. W. (1992). Overview. In Principles and Practice of Radiation Oncology, 2nd edn, Perez CA and Brady LW (eds), pp. 51–55. Lippincott: Philadelphia
Sedgwick, D. M., Howard, G. C. & Ferguson, A. (1994). Pathogenesis of acute radiation injury to the rectum. A prospective study in patients. Int J Colorectal Dis 9: 23–30.
Sprangers, M. A., Taal, B. G., Aaronson, N. K. & te Velde, A. (1995). Quality of life in colorectal cancer. Stoma vs. nonstoma patients. Dis Colon Rectum 38: 361–369.
Touboul, E., Schlienger, M., Buffat, L., Lefkopoulos, D., Pène, F., Parc, R. & Tiret, E. (1994). Epidermoid carcinoma of the anal canal. Results of curative-intent radiation therapy in a series of 270 patients. Cancer 73: 1570–1579.
Williams, N. S. & Johnston, D. (1983). The quality of life after rectal excision for low rectal cancer. Br J Surg 70: 460–462.
Yeoh, E., Horowitz, M., Russo, A., Muecke, T., Robb, T., Maddox, A. & Chatterton, B. (1993). Effect of pelvic irradiation on gastrointestinal function: a prospective longitudinal study. Am J Med 95: 397–406.
Yeoh, E., Sun, W. M., Russo, A., Ibanez, L. & Horowitz, M. (1996). A retrospective study of the effects of pelvic irradiation for gynecological cancer on anorectal function. Int J Radiat Oncol Biol Phys 35: 1003–1010.
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Allal, A., Sprangers, M., Laurencet, F. et al. Assessment of long-term quality of life in patients with anal carcinomas treated by radiotherapy with or without chemotherapy. Br J Cancer 80, 1588–1594 (1999). https://doi.org/10.1038/sj.bjc.6690567
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DOI: https://doi.org/10.1038/sj.bjc.6690567
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