LATE SIDE EFFECTS AND QUALITY OF LIFE AFTER RADIOTHERAPY FOR RECTAL CANCER
LATE SIDE EFFECTS AND QUALITY OF LIFE AFTER RADIOTHERAPY FOR RECTAL CANCER
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DOI：
10.1016/j.ijrobp.2009.03.010
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发表时间：
2010-03-15
影响因子：
7
通讯作者：
Tveit, Kjell Magne
中科院分区：
文献类型：
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作者：
Bruheim, Kjersti;Guren, Marianne G.;Tveit, Kjell Magne
目的：对直肠癌放疗（50戈伊）和全直肠系膜切除术后的长期发病率知之甚少。因此，肠，肛门直肠，泌尿功能，健康相关的生活质量（QoL），在一个国家的队列（n = 535）进行了研究的后期影响：方法和材料：所有挪威患者接受术前或术后（化疗）放疗直肠癌从1993年至2003年进行了鉴定。仅接受手术治疗的患者作为对照组。患者均无复发或转移。肠和尿功能评分与LENT索马量表和圣马克评分大便失禁和生活质量与欧洲癌症研究和治疗组织（EORTC）的生活质量问卷（QLQ-C30）。结果：手术后的中位时间为4.8年。放射治疗（RT+）患者（n = 199）与非放射治疗（RT-）患者（n = 336）相比，排便频率增加; 19% vs. 6%的患者每天排便超过8次（p < 0.001）。在没有造口的患者中，RT+患者（n = 69）的比例高于RT-患者（n = 240），有液体粪便失禁（49% vs. 15%，p < 0.001），需要卫生巾（52% vs. 13%，p < 0.001），缺乏延迟排便的能力（44% vs. 16%，p < 0.001）。放疗后每日尿失禁发生率更高（9% vs. 2%，p = 0.001）。放射治疗患者的社会功能比RT-患者差，大便或尿失禁患者的整体生活质量和社会功能评分受损（p < 0.001）。结论：直肠癌放射治疗对肛门直肠功能有相当大的长期影响，特别是在排便频率和大便失禁方面。RT+患者的社会功能较差，大便失禁对生活质量有负面影响。(C)2010年爱思唯尔公司
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 Or = 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. (C) 2010 Elsevier Inc.