Sodergren Samantha C, Vassiliou Vassilios, Dennis Kristopher, Tomaszewski Krzysztof A, Gilbert Alexandra, Glynne-Jones Robert, Nugent Karen, Sebag-Montefiore David, Johnson Colin D
Cancer Sciences, University of Southampton, Southampton, SO16 6YD, UK.
Bank of Cyprus Oncology Centre, Nicosia, Cyprus.
Support Care Cancer. 2015 Dec;23(12):3613-23. doi: 10.1007/s00520-015-2879-2. Epub 2015 Aug 20.
Radiochemotherapy is the standard of care for the treatment of anal carcinoma achieving good loco-regional control and sphincter preservation. This approach is however associated with acute and late toxicities including haematological, skin, bowel function and genito-urinary complications. This paper systematically reviews studies addressing the quality of life (QoL) implications of anal cancer and radiochemotherapy. The paper also evaluates how QoL is assessed in anal cancer.
Medline, EMBASE, CINAHL, PsycInfo, Web of Science and the Cochrane Library were searched for publications (1996-2014) reporting the effects on patients of anal cancer and radiochemotherapy.
Of the 152 papers reporting treatment-related effects on patients, only 11 provided a formal assessment of QoL. In the absence of an anal cancer-specific measure, QoL was assessed using generic cancer instruments such as the core EORTC quality of life questionnaire (EORTC QLQ-C30) or colorectal cancer tools such as the EORTC QLQ-CR29. Bowel function, particularly diarrhoea, and sexual problems were the most commonly reported QoL concerns. The review of QoL issues of anal cancer patients treated with radiochemotherapy is limited by the QoL assessment measures used. It is argued that certain treatment-related toxicities, for example skin-induced radiation problems, are overlooked or inadequately represented in existing measures.
This review emphasises the need to develop an anal cancer-specific QoL measure and to incorporate QoL as an outcome of future trials in anal cancer. The results of this review are informative to clinicians and patients in terms of treatment decision-making.
放化疗是肛管癌治疗的标准护理方式，可实现良好的局部区域控制并保留括约肌。然而，这种方法会引发急性和晚期毒性反应，包括血液学、皮肤、肠道功能和泌尿生殖系统并发症。本文系统回顾了有关肛管癌及放化疗对生活质量（QoL）影响的研究。本文还评估了肛管癌中生活质量是如何被评估的。
检索了Medline、EMBASE、CINAHL、PsycInfo、Web of Science和Cochrane图书馆，查找1996年至2014年期间报告肛管癌及放化疗对患者影响的出版物。
在152篇报告治疗对患者相关影响的论文中，只有11篇对生活质量进行了正式评估。在缺乏肛管癌特异性测量方法的情况下，使用通用癌症工具（如欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ-C30））或结直肠癌工具（如EORTC QLQ-CR29）来评估生活质量。肠道功能，尤其是腹泻和性问题是最常报告的生活质量问题。对接受放化疗的肛管癌患者生活质量问题的回顾受到所使用的生活质量评估措施的限制。有人认为，某些与治疗相关的毒性反应，例如皮肤引起的放射问题，在现有措施中被忽视或体现不足。
本综述强调需要开发一种肛管癌特异性生活质量测量方法，并将生活质量纳入未来肛管癌试验的结果中。本综述的结果在治疗决策方面对临床医生和患者具有参考价值。
