Yerramilli Divya, Drapek Lorraine, Nipp Ryan D, Horick Nora, Moran Samantha M C, Noé Bridget, D'Arpino Sara M, Mitra Devarati, Hong Theodore S, Ryan David P, Dizon Don S, Wo Jennifer
Department of Radiation Oncology, Massachusetts General Hospital, Lunder LL2, 55 Fruit Street, Boston, MA, 02114, USA.
Division of Medical Oncology, Massachusetts General Hospital Cancer Center, Boston, MA, USA.
J Gastrointest Cancer. 2020 Mar;51(1):204-210. doi: 10.1007/s12029-019-00233-w.
PURPOSE/OBJECTIVE(S): Definitive chemoradiation (CRT) results in high cure rates of anal cancer, with advanced radiation (RT) techniques improving toxicity. However, there is limited data regarding these patients' sexual function (SF), quality of life (QOL), and mood. We hypothesized that anal cancer treatment would result in detrimental effects on SF, QOL, and mood.
MATERIALS/METHODS: We prospectively surveyed patients with anal cancer treated with definitive CRT. We assessed SF for women with the Female Sexual Function Index (FSFI) and for men with the International Index of Erectile Function (IIEF). For all patients, we assessed QOL using EORTC QLQ-C30 and CR29 and mood using the Hospital Anxiety and Depression Scale (HADS). We reported descriptive statistics for SF, QOL, and mood and used univariate analysis to evaluate predictors of SF for women.
Of 50 eligible patients, 84% completed the surveys. Median time from RT until survey was 36 months (1-97 months). Women (n = 34) reported poor SF overall (mean FSFI score = 15, scale 2-36, standard deviation (SD) 10.4). Most women reported poor SF related to satisfaction, desire, orgasm, arousal, pain, and lubrication. Men (n = 8) also had poor overall satisfaction (mean IIEF score = 6.1, scale 2-10, SD 3.6). Men reported poor erectile function and lower satisfaction with intercourse. Mean QLQ-C30 QOL score was 86.5 (SD 16.3). Results from EORTC QLQ-CR-20 demonstrated patients experienced poor sexual interest. Per HADS, 2.5% reported depression and 18% anxiety.
Patients with anal cancer experience sexual dysfunction after RT, with QOL and mood symptoms similar to patients with other cancers. Our data support the need for ongoing efforts to understand and address issues with SF, QOL, and mood following RT for these patients.
根治性放化疗（CRT）可使肛管癌获得较高的治愈率，先进的放疗（RT）技术可降低毒性。然而，关于这些患者性功能（SF）、生活质量（QOL）和情绪的资料有限。我们推测肛管癌治疗会对性功能、生活质量和情绪产生不利影响。
我们对接受根治性CRT治疗的肛管癌患者进行了前瞻性调查。我们使用女性性功能指数（FSFI）评估女性的性功能，使用国际勃起功能指数（IIEF）评估男性的性功能。对于所有患者，我们使用欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ-C30）和CR29评估生活质量，使用医院焦虑抑郁量表（HADS）评估情绪。我们报告了性功能、生活质量和情绪的描述性统计数据，并使用单因素分析评估女性性功能的预测因素。
50例符合条件的患者中，84%完成了调查。从放疗至调查的中位时间为36个月（1 - 97个月）。女性（n = 34）总体性功能较差（FSFI平均得分 = 15，范围2 - 36，标准差（SD）10.4）。大多数女性报告在满意度、性欲、性高潮、性唤起、疼痛和润滑方面性功能较差。男性（n = 8）总体满意度也较低（IIEF平均得分 = 6.1，范围2 - 10，SD 3.6）。男性报告勃起功能差，对性交的满意度较低。EORTC QLQ-C30生活质量平均得分为86.5（SD 16.3）。EORTC QLQ-CR-20结果显示患者性兴趣较差。根据HADS，2.5%的患者报告有抑郁，18%的患者报告有焦虑。
肛管癌患者放疗后出现性功能障碍，其生活质量和情绪症状与其他癌症患者相似。我们的数据支持持续努力去了解和解决这些患者放疗后性功能、生活质量和情绪方面问题的必要性。
