Ribas Yolanda, Bonet Marta, Torres Laura, Núñez Miriam, Esther Jovell-Fernández E, Aranda Eduard, Andreyev H Jervoise
Department of Surgery, Consorci Sanitari de Terrassa, 08227, Terrassa, Barcelona, Spain.
Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Reus, Spain.
Support Care Cancer. 2020 Nov;28(11):5501-5510. doi: 10.1007/s00520-020-05402-3. Epub 2020 Mar 14.
To assess the prevalence of bowel dysfunctions after treatment for gynaecological cancer and the impact on the quality of life.
We identified a cohort of 217 eligible women treated with radiotherapy (RT) with curative intention, alone or as combined treatment, for gynaecological malignancies at three institutions in Catalonia (Spain). Demographic, diagnosis and treatment modality were reviewed. Patients were sent validated questionnaires to assess bowel function and a set of questions asking on the changes after RT in bowel function, urinary function, sexuality, pain and lymphoedema.
Questionnaires were returned by 109 patients (50.2%) with a mean age of 65 ± 11 years. Of them, 71.8% had been treated for endometrial cancer and 28.2% for cervical cancer. Overall, 42.7% of patients reported bowel dysfunction, affecting their quality of life in 36% of cases. Symptoms were more frequent in patients who had undergone external beam RT compared to brachytherapy. The most common symptom was defecatory urgency which was reported by more than 40% of patients according to the St Mark's score, although it was less common in other questionnaires. Overall, faecal incontinence ranged between 10 and 15%, and usual loose stools and diarrhoea were reported by 13.5% and 5.1%, respectively.
Prevalence of bowel symptoms after treatment of gynaecological malignancies is high. A systematic evaluation using validated questionnaires should be performed in order to allow the decision-making process and also because there are a number of treatments available to improve the quality of life of cancer survivors.
评估妇科癌症治疗后肠道功能障碍的患病率及其对生活质量的影响。
我们确定了一组217名符合条件的女性，她们在西班牙加泰罗尼亚的三家机构接受了旨在治愈的放射治疗（RT），单独或作为联合治疗，用于治疗妇科恶性肿瘤。回顾了人口统计学、诊断和治疗方式。向患者发送经过验证的问卷，以评估肠道功能，并询问一系列关于放疗后肠道功能、泌尿功能、性功能、疼痛和淋巴水肿变化的问题。
109名患者（50.2%）返回了问卷，平均年龄为65±11岁。其中，71.8%接受了子宫内膜癌治疗，28.2%接受了宫颈癌治疗。总体而言，42.7%的患者报告有肠道功能障碍，其中36%的病例影响了他们的生活质量。与近距离放疗相比，接受外照射放疗的患者症状更频繁。最常见的症状是排便急迫感，根据圣马克评分，超过40%的患者报告有此症状，尽管在其他问卷中不太常见。总体而言，大便失禁的发生率在10%至15%之间，分别有13.5%和5.1%的患者报告有经常稀便和腹泻。
妇科恶性肿瘤治疗后肠道症状的患病率很高。应使用经过验证的问卷进行系统评估，以便进行决策，同时也因为有多种治疗方法可用于提高癌症幸存者的生活质量。
