Impaired health-related quality of life after chemoradiotherapy for anal cancer: Late effects in a national cohort of 128 survivors
Impaired health-related quality of life after chemoradiotherapy for anal cancer: Late effects in a national cohort of 128 survivors
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DOI：
10.3109/0284186x.2013.770599
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发表时间：
2013-05-01
期刊：
影响因子：
3.1
通讯作者：
Guren, Marianne Gronlie
中科院分区：
文献类型：
--
作者：
Bentzen, Anne Gry;Balteskard, Lise;Guren, Marianne Gronlie
背景。放化疗是肛门癌的一种有效治疗方法，但从随访来看，许多幸存者似乎患有晚期效应。肛门癌幸存者的长期健康相关生活质量（HRQOL）数据有限，人们对癌症幸存者的兴趣越来越大。材料和方法。在2000-2007年接受治疗性放化疗的所有肛门癌幸存者的国家队列被邀请进行横断面研究。在199名符合条件的幸存者中，128名（64%）返回了问卷，自诊断以来的中位时间为66个月。中位年龄为61岁，79%为女性。HRQOL采用EORTC问卷QLQ-C30和QLQ-CR29评估，神经毒性采用化疗诱导神经毒性量表评估。未接受盆腔癌治疗的年龄和性别匹配的对照组志愿者（n = 269）回答了相同的问卷。参照组的QLQ-C30结果与挪威和荷兰的标准数据进行比较。结果。与志愿者和规范数据相比，肛门癌幸存者的平均得分较低。与志愿者相比，肛门癌幸存者报告了显著的功能障碍，尤其是社交和角色功能（差异>= 20分，p < 0.001）。幸存者在疲劳、呼吸困难、失眠和腹泻方面的得分明显增加（差异>= 15分，p < 0.001）。总体生活质量显著降低（差异15分，p < 0.001）。肛门癌幸存者大便频率增加、臀部疼痛、胀气、大便失禁、阳痿（男性）、性交困难和性兴趣降低（女性）（差异>= 15分，p < 0.001）。接受顺铂化疗的幸存者耳鸣频率增加（p = 0.004）。结论。肛门癌放化疗后的幸存者HRQOL有显著的长期损害。社交、角色和性功能下降，腹泻、大小便失禁和臀部疼痛增加。提高对这一点的认识可能会导致更好地管理晚期影响和更好地照顾癌症幸存者。
Background. Chemoradiotherapy is an effective treatment for anal cancer, yet from follow-up many survivors seem to suffer from late effects. Data of long-term health-related quality of life (HRQOL) in anal cancer survivors are limited, and there is a growing interest in cancer survivorship. Material and methods. A national cohort of all anal cancer survivors treated with curative chemoradiotherapy in 2000-2007 was invited to a cross-sectional study. Of 199 eligible survivors, 128 (64%) returned the questionnaires, the median time since diagnosis was 66 months. The median age was 61 years and 79% were women. HRQOL was evaluated with EORTC questionnaires QLQ-C30 and QLQ-CR29, and neurotoxicity with the Scale of Chemotherapy-Induced Neurotoxicity. An age-and sex-matched reference group of volunteers (n = 269) not treated for pelvic cancer answered the same questionnaires. Results from QLQ-C30 of the reference group were compared to Norwegian and Dutch normative data. Results. The mean scores of anal cancer survivors were poorer compared to volunteers and normative data. Anal cancer survivors reported significant impairment of function, especially social and role function, compared to the volunteers (difference >= 20 points, p < 0.001). Survivors had markedly increased scores for fatigue, dyspnoea, insomnia and diarrhoea (difference >= 15 points, p < 0.001). The global quality of life was significantly reduced (difference 15 points, p < 0.001). Anal cancer survivors had increased stool frequency, more buttock pain, flatulence, faecal incontinence, impotence (males), dyspareunia and reduced sexual interest (females) (difference >= 15 points, p < 0.001). There was increased frequency of tinnitus in survivors treated with cisplatin-based chemotherapy (p = 0.004). Conclusions. Survivors after chemoradiotherapy for anal cancer have significant long-term impairment of HRQOL. Reduced social, role and sexual function, and increased diarrhoea, incontinence for gas and stools, and buttock pain were commonly reported. Increased awareness of this may lead to better management of late effects and better care for cancer survivors.