دورية أكاديمية
Patient-Reported Bowel and Urinary Function in Long-Term Survivors of Squamous Cell Carcinoma of the Anus Treated With Definitive Intensity Modulated Radiation Therapy And Concurrent Chemotherapy.
| العنوان: | Patient-Reported Bowel and Urinary Function in Long-Term Survivors of Squamous Cell Carcinoma of the Anus Treated With Definitive Intensity Modulated Radiation Therapy And Concurrent Chemotherapy. |
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| المؤلفون: | De B; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology., Corrigan KL; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology., Rooney MK; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology., Ludmir EB; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology; Department of Biostatistics., Das P; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology., Smith GL; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology; Department of Health Services Research., Taniguchi CM; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology., Minsky BD; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology., Koay EJ; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology., Koong A; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology., Morris VK; Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine., Messick CA; Department of Colon and Rectal Surgery, Division of Surgery., You YN; Department of Colon and Rectal Surgery, Division of Surgery., Chang GJ; Department of Health Services Research; Department of Colon and Rectal Surgery, Division of Surgery., Westney OL; Department of Urology, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas., Nogueras Gonzalez GM; Department of Biostatistics., Holliday EB; Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology. Electronic address: ebholliday@mdanderson.org. |
| المصدر: | International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2022 Sep 01; Vol. 114 (1), pp. 78-88. Date of Electronic Publication: 2022 May 16. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier, Inc Country of Publication: United States NLM ID: 7603616 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-355X (Electronic) Linking ISSN: 03603016 NLM ISO Abbreviation: Int J Radiat Oncol Biol Phys Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York, NY : Elsevier, Inc Original Publication: Elmsford, N. Y., Pergamon Press. |
| مواضيع طبية MeSH: | Anus Neoplasms*/therapy , Carcinoma, Squamous Cell*/radiotherapy , Fecal Incontinence*/etiology , Rectal Neoplasms*/pathology, Anal Canal ; Cross-Sectional Studies ; Female ; Humans ; Male ; Patient Reported Outcome Measures ; Postoperative Complications ; Quality of Life ; Survivors ; Syndrome |
| مستخلص: | Purpose: Definitive radiation therapy with concurrent chemotherapy is curative for nonmetastatic squamous cell carcinoma of the anus (SCCA). However, the true effect of chemoradiation on long-term functional outcomes is poorly understood owing to limited follow-up and patient-reported outcomes (PROs). Methods and Materials: We conducted a cross-sectional survey of 248 patients with SCCA treated with definitive intensity modulated radiation and concurrent chemotherapy from 2010 to 2018 who were alive and without recurrence. PRO measures were collected, including Functional Assessment of Cancer Therapy-General (FACT-G7), Fecal Incontinence Quality of Life (FIQoL), Low Anterior Resection Syndrome (LARS), and International Consultation on Incontinence Questionnaires (ICIQ). Models were used to determine the association between demographic, tumor, treatment, and dosimetric data with PROs. Results: One hundred twelve (45%) patients completed PROs. Median [interquartile range (IQR)] time from radiation completion to survey was 51 [37-85] months. The median scores [IQR] for FACT-G7, FIQoL, and LARS were 21 [15-24], 14 [11-16], and 32 [25-37], respectively. For men, median subscores [IQR] for ICIQ voiding and incontinence subscores were 5 [2-6] and 1 [1-3], respectively. For women, median subscores [IQR] for ICIQ voiding, incontinence, and filling were 1 [1-3], 5 [3-8], and 4 [2-5], respectively. Higher (better) FIQoL scores were associated with higher (better) FACT-G7 scores (β = 0.83; 95% confidence interval, 0.58-1.09; P < .001), and higher (worse) LARS scores were associated with lower (worse) FACT-G7 scores (β = -0.22; 95% confidence interval, -0.31 to -0.13; P < .001). A separate multivariable analysis revealed higher bowel bag D1% was associated with lower (worse) FIQoL (P = .001) and higher (worse) LARS (P = .003) scores. Higher bladder V40 Gy was associated with increased (worse) ICIQ voiding subscore (P = .001). Conclusions: Patients treated with modern chemoradiation for SCCA experience significant long-term bowel toxic effects with considerable effect on quality of life. Minimizing bowel hotspots and bladder V40 Gy may improve bowel and urinary function. Other interventions to reduce long-term toxic effects and improve quality of life are needed. (Copyright © 2022 Elsevier Inc. All rights reserved.) |
| معلومات مُعتمدة: | P30 CA016672 United States CA NCI NIH HHS |
| تواريخ الأحداث: | Date Created: 20220519 Date Completed: 20220816 Latest Revision: 20220916 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.ijrobp.2022.05.009 |
| PMID: | 35589011 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-355X |
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| DOI: | 10.1016/j.ijrobp.2022.05.009 |