A modified Inflammatory Bowel Disease questionnaire and the Vaizey Incontinence questionnaire are simple ways to identify patients with significant gastrointestinal symptoms after pelvic radiotherapy
A modified Inflammatory Bowel Disease questionnaire and the Vaizey Incontinence questionnaire are simple ways to identify patients with significant gastrointestinal symptoms after pelvic radiotherapy
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DOI：
10.1038/sj.bjc.6602552
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发表时间：
2005-05-09
影响因子：
8.8
通讯作者：
Andreyev, HJN
中科院分区：
文献类型：
--
作者：
Olopade, FA;Norman, A;Andreyev, HJN
盆腔癌放疗后，慢性胃肠道问题可能影响6 - 78%患者的生活质量（QOL）。这种变化可能是由于不同疾病的结果确实存在差异，也可能代表用于测量放疗引起的胃肠道副作用的量表的不足。本研究的目的是评估用于非恶性胃肠道疾病的结局指标是否有助于检测放射治疗后胃肠道疾病的发病率。从Vaizey Inflammatory问卷和改良的炎症性肠病问卷（IBDQ）获得的结果（两名患者均已完成）与工作人员对至少3个月前完成盆腔肿瘤放疗的患者进行的正常组织晚期效应（LENT）-主观、客观、管理和分析（SOMA）问卷的结果进行了比较。总共招募了142名连续患者，72名男性和70名女性，中位年龄66岁（范围26 - 90岁），放疗后中位时间为27个月（范围3 - 258）。总共有62人接受了妇科肿瘤治疗，58人接受了泌尿系统肿瘤治疗，22人接受了胃肠道肿瘤治疗。其中21人曾接受过胃肠道手术，7人在诊断为癌症之前患有慢性胃肠道疾病。Vaizey问卷调查显示，27%的患者固体粪便失禁，35%的液体粪便失禁，37%的患者不能延迟排便15分钟。IBDQ表明，89%的患者出现了排便习惯的慢性变化，这种变化显著影响了49%的患者：44%的人排便更频繁或更松散，30%的人受到腹痛的困扰，30%的人受到腹胀的困扰，28%的人抱怨里急后重，27%的人受到意外弄脏的困扰，20%的人有直肠出血。至少有34%的人因排便而遭受情绪困扰，22%的人因排便而损害社会功能。小肠/结肠SOMA中位数评分为0.1538（范围0 - 1），直肠SOMA中位数评分为0.1428（范围0 - 1）。IBDQ评分和小肠/结肠SOMA评分的Pearson相关性为-0.630 IBDQ和直肠SOMA为-0.616 IBDQ和Vaizey评分为-0.599（P <0.001）Vaizey与小肠/结肠SOMA 0.452（P <0.001），Vaizey与直肠SOMA 0.760（P <0.001）。盆腔肿瘤放疗后，半数患者出现胃肠道疾病，影响其生活质量。改良的IBDQ和Vaizey问卷在评估新的胃肠道症状以及总体QOL方面是可靠的，并且比LENT SOMA更容易使用。
After radiotherapy for pelvic cancer, chronic gastrointestinal problems may affect quality of life (QOL) in 6-78% of patients. This variation may be due to true differences in outcome in different diseases, and may also represent the inadequacy of the scales used to measure radiotherapy-induced gastrointestinal side effects. The aim of this study was to assess whether outcome measures used for nonmalignant gastrointestinal disease are useful to detect gastrointestinal morbidity after radiotherapy. Results obtained from a Vaizey Incontinence questionnaire and a modified Inflammatory Bowel Disease questionnaire (IBDQ) - both patient completed - were compared to those from a staff administered Late Effects on Normal Tissue (LENT) - Subjective, Objective, Management and Analytic (SOMA) questionnaire in patients who had completed radiotherapy for a pelvic tumour at least 3 months previously. In all, 142 consecutive patients were recruited, 72 male and 70 female, median age 66 years (range 26 - 90 years), a median of 27 (range 3 - 258) months after radiotherapy. In total, 62 had been treated for a gynaecological, 58, a urological and 22, a gastrointestinal tract tumour. Of these, 21 had undergone previous gastrointestinal surgery and seven suffered chronic gastrointestinal disorders preceding their diagnosis of cancer. The Vaizey questionnaire suggested that 27% patients were incontinent for solid stools, 35% for liquid stools and 37% could not defer defaecation for 15 min. The IBDQ suggested that 89% had developed a chronic change in bowel habit and this change significantly affected 49% patients: 44% had more frequent or looser bowel movements, 30% were troubled by abdominal pain, 30% were troubled by bloating, 28% complained of tenesmus, 27% were troubled by their accidental soiling and 20% had rectal bleeding. At least 34% suffered emotional distress and 22% impairment of social function because of their bowels. The small intestine/colon SOMA median score was 0.1538 (range 0-1) and the rectal SOMA median score was 0.1428 (range 0-1). Pearson's correlations for the IBDQ score and small intestine/colon SOMA score was -0.630 (P < 0.001), IBDQ and rectum SOMA -0.616 (P < 0.001), IBDQ and Vaizey scores -0.599 (P < 0.001), Vaizey and small intestine/colon SOMA 0.452 (P < 0.001) and Vaizey and rectum SOMA 0.760 (P < 0.001). After radiotherapy for a tumour in the pelvis, half of all patients develop gastrointestinal morbidity, which affects their QOL. A modified IBDQ and Vaizey questionnaire are reliable in assessing new gastrointestinal symptoms as well as overall QOL and are much easier to use than LENT SOMA.