PURPOSE: Among patients with anal cancer, chemoradiotherapy is often associated with toxicities that diminish quality of life. We describe the GI-related patient-reported outcomes (PROs) of patients with anal cancer receiving chemoradiotherapy to improve patient-physician communication. METHODS: We prospectively followed patients with nonmetastatic squamous cell carcinoma of the anal canal who received definitive chemoradiotherapy. Patients completed the bowel subdomain of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire before treatment and at 4 subsequent timepoints. We used the paired Wilcoxon test to compare EPIC scores at different times. RESULTS: The study included 21 patients; median age was 57 years. Most patients (52%) had T2 and either N0 or N1 disease (81%). Most patients (91%) received chemotherapy with cisplatin-fluorouracil and either intensity-modulated radiotherapy or volumetric modulated arc therapy. Compared with the patients' median overall summary score at baseline (66), their median score at 1 week (82) was higher (P = .009), whereas their median score at 5 weeks (54) was lower (P = .025). The patients' median overall summary score at baseline and at 3 months did not differ (P = .919). Three months after radiotherapy, most patients reported minimal adverse effects compared with baseline. CONCLUSION: The GI-related PROs of patients with anal cancer tend to fluctuate during radiotherapy but return to baseline by 3 months, at which time most patients report few or no residual adverse effects. We provide a clear timeline of GI acute toxicity using sequential PRO measurements that will improve patient-physician communication regarding expectations for cancer treatment.
PURPOSE: Among patients with anal cancer, chemoradiotherapy is often associated with toxicities that diminish quality of life. We describe the GI-related patient-reported outcomes (PROs) of patients with anal cancer receiving chemoradiotherapy to improve patient-physician communication. METHODS: We prospectively followed patients with nonmetastatic squamous cell carcinoma of the anal canal who received definitive chemoradiotherapy. Patients completed the bowel subdomain of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire before treatment and at 4 subsequent timepoints. We used the paired Wilcoxon test to compare EPIC scores at different times. RESULTS: The study included 21 patients; median age was 57 years. Most patients (52%) had T2 and either N0 or N1 disease (81%). Most patients (91%) received chemotherapy with cisplatin-fluorouracil and either intensity-modulated radiotherapy or volumetric modulated arc therapy. Compared with the patients' median overall summary score at baseline (66), their median score at 1 week (82) was higher (P = .009), whereas their median score at 5 weeks (54) was lower (P = .025). The patients' median overall summary score at baseline and at 3 months did not differ (P = .919). Three months after radiotherapy, most patients reported minimal adverse effects compared with baseline. CONCLUSION: The GI-related PROs of patients with anal cancer tend to fluctuate during radiotherapy but return to baseline by 3 months, at which time most patients report few or no residual adverse effects. We provide a clear timeline of GI acute toxicity using sequential PRO measurements that will improve patient-physician communication regarding expectations for cancer treatment.
Authors: Anne Gry Bentzen; Lise Balteskard; Eva Hoff Wanderås; Gunilla Frykholm; Tom Wilsgaard; Olav Dahl; Marianne Grønlie Guren Journal: Acta Oncol Date: 2013-02-26 Impact factor: 4.089
Authors: M Flam; M John; T F Pajak; N Petrelli; R Myerson; S Doggett; J Quivey; M Rotman; H Kerman; L Coia; K Murray Journal: J Clin Oncol Date: 1996-09 Impact factor: 44.544
Authors: Martin G Sanda; Rodney L Dunn; Jeff Michalski; Howard M Sandler; Laurel Northouse; Larry Hembroff; Xihong Lin; Thomas K Greenfield; Mark S Litwin; Christopher S Saigal; Arul Mahadevan; Eric Klein; Adam Kibel; Louis L Pisters; Deborah Kuban; Irving Kaplan; David Wood; Jay Ciezki; Nikhil Shah; John T Wei Journal: N Engl J Med Date: 2008-03-20 Impact factor: 91.245
Authors: Kathy Han; Bernard J Cummings; Patricia Lindsay; Julia Skliarenko; Tim Craig; Lisa W Le; James Brierley; Rebecca Wong; Robert Dinniwell; Andrew J Bayley; Laura A Dawson; Jolie Ringash; Monika K Krzyzanowska; Malcolm J Moore; Eric X Chen; Alexandra M Easson; Zahra Kassam; Charles Cho; John Kim Journal: Int J Radiat Oncol Biol Phys Date: 2014-09-03 Impact factor: 7.038