Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston1515 Holcombe Boulevard, Unit 97, Houston, TX 77030, USA.
Cancer. 2010 Feb 15;116(4):822-9. doi: 10.1002/cncr.24906.
Radiotherapy is the current standard of care for patients with localized squamous cell cancer of the anal canal. The goal of the current study was to evaluate long-term quality of life (QoL) in patients after this treatment.
Questionnaires were mailed to 80 patients treated with definitive radiotherapy, with or without concurrent chemotherapy, for anal cancer, with a minimum 2-year interval after the completion of radiotherapy. The questionnaire included the Functional Assessment of Cancer Therapy-Colorectal (FACT-C), the Medical Outcomes Study (MOS) Sexual Problems Scale, and questions regarding demographic characteristics and comorbidities.
A total of 32 (40%) patients completed the questionnaire. There were no significant differences noted with regard to clinical and demographic characteristics between the survey responders and nonresponders. Among the 32 responders, the median dose of radiotherapy was 55 Grays (Gy), and 97% had received concurrent chemotherapy. The median interval between radiotherapy and survey participation was 5 years (range, 3-13 years). The median total FACT-C score was 108 (range, 47-128), of a maximum (best possible) score of 136. Patients who reported depression or anxiety and younger patients were found to have significantly lower total FACT-C scores. The median scores on the Physical, Social/Family, Emotional, Functional, and Colorectal subscales of the FACT-C were 20, 23, 21, 22, and 21, respectively, of maximum (best possible) scores of 28, 28, 24, 28, and 28, respectively. The median score on the MOS Sexual Problems Scale was 67 (range, 0-100), of a maximum (worst possible) score of 100.
Patients treated with radiotherapy for anal cancer reported acceptable overall QoL scores, but poor sexual function scores. Investigations are warranted into more modern radiation techniques that could potentially reduce late toxicity from radiotherapy.
放射治疗是目前治疗局部肛管鳞癌患者的标准方法。本研究的目的是评估接受根治性放疗（联合或不联合同期化疗）的患者的长期生活质量（QoL）。
对 80 例接受根治性放疗（联合或不联合同期化疗）的肛管癌患者进行问卷调查，这些患者在放疗结束后至少 2 年。问卷包括癌症治疗功能评估-结直肠癌（FACT-C）、医疗结局研究（MOS）性问题量表以及与人口统计学特征和合并症相关的问题。
共有 32 例（40%）患者完成了问卷。在调查应答者和未应答者之间，在临床和人口统计学特征方面没有显著差异。在 32 名应答者中，放疗的中位剂量为 55 戈瑞（Gy），97%接受了同期化疗。放疗与调查参与之间的中位时间间隔为 5 年（范围，3-13 年）。中位 FACT-C 总分为 108（范围，47-128），满分为 136。报告抑郁或焦虑的患者和年轻患者的 FACT-C 总分明显较低。FACT-C 的身体、社会/家庭、情感、功能和结直肠子量表的中位评分分别为 20、23、21、22 和 21，满分为 28、28、24、28 和 28。MOS 性问题量表的中位评分为 67（范围，0-100），满分为 100。
接受放疗治疗的肛管癌患者报告了可接受的总体 QoL 评分，但性功能评分较差。有必要研究更现代的放射治疗技术，这些技术可能会降低放疗的迟发性毒性。
