Late Side Effects and Quality of Life After Radiotherapy for Rectal Cancer

Journal Article · Mon Mar 15 04:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.03.010· OSTI ID:21372153

Bruheim, Kjersti ^[1]; Guren, Marianne G ^[1]; Skovlund, Eva ^[2]; Hjermstad, Marianne J ^[1]; Dahl, Olav ^[3]; Frykholm, Gunilla ^[4]; Carlsen, Erik ^[5]; Tveit, Kjell Magne ^[1]

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1. Cancer Centre, Oslo University Hospital, Ulleval, Oslo (Norway)
2. School of Pharmacy, University of Oslo, Oslo (Norway)
3. Section of Oncology, Institute of Medicine and Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen (Norway)
4. Department of Oncology, St Olavs Hospital, Trondheim (Norway)
5. Department of Gastrointestinal Surgery, Oslo University Hospital, Ulleval, Oslo (Norway)

Purpose: There is little knowledge on long-term morbidity after radiotherapy (50 Gy) and total mesorectal excision for rectal cancer. Therefore, late effects on bowel, anorectal, and urinary function, and health-related quality of life (QoL), were studied in a national cohort (n = 535). Methods and Materials: All Norwegian patients who received pre- or postoperative (chemo-)radiotherapy for rectal cancer from 1993 to 2003 were identified. Patients treated with surgery alone served as controls. Patients were without recurrence or metastases. Bowel and urinary function was scored with the LENT SOMA scale and the St. Marks Score for fecal incontinence and QoL with the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). Results: Median time since surgery was 4.8 years. Radiation-treated (RT+) patients (n = 199) had increased bowel frequency compared with non-radiation-treated (RT-) patients (n = 336); 19% vs. 6% had more than eight daily bowel movements (p < 0.001). In patients without stoma, a higher proportion of RT+ (n = 69) compared with RT- patients (n = 240), were incontinent for liquid stools (49% vs. 15%, p < 0.001), needed a sanitary pad (52% vs. 13%, p < 0.001), and lacked the ability to defer defecation (44% vs. 16%, p < 0.001). Daily urinary incontinence occurred more frequently after radiotherapy (9% vs. 2%, p = 0.001). Radiation-treated patients had worse social function than RT- patients, and patients with fecal or urinary incontinence had impaired scores for global quality of life and social function (p < 0.001). Conclusions: Radiotherapy for rectal cancer is associated with considerable long-term effects on anorectal function, especially in terms of bowel frequency and fecal incontinence. RT+ patients have worse social function, and fecal incontinence has a negative impact on QoL.

• OSTI ID: 21372153
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 76; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
DIGESTIVE SYSTEM
DISEASES
GASTROINTESTINAL TRACT
INTESTINES
LARGE INTESTINE
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
RADIOTHERAPY
RECTUM
SIDE EFFECTS
STANDARD OF LIVING
THERAPY