Than Ngu Wah, Pritchard D Mark, Hughes David M, Duckworth Carrie A, Haq Muneeb Ul, Cummings Thomas, Jardine Charlotte, Stead Sarah, Sripadam Rajaram, Myint Arthur Sun
Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, The University of Liverpool, Liverpool L69 3GE, UK.
The Clatterbridge Cancer Centre NHS Foundation Trust, 65 Pembroke Place, Liverpool L7 8YA, UK.
Cancers (Basel). 2025 May 3;17(9):1560. doi: 10.3390/cancers17091560.
With recent advancements in rectal cancer management leading to longer patient survival, the impact of various treatment approaches on patients' quality of life (QOL) becomes an important focus of attention. While QOL studies exist for watch-and-wait after (chemo)radiation with/without local excision, data on health-related QOL (HRQOL) outcomes after contact X-ray brachytherapy (CXB) remain limited. This study evaluated functional and HRQOL outcomes in rectal cancer patients undergoing CXB and (chemo)radiation over one year. This prospective observational study (enrolment January-October 2023) with one-year follow-up assessed functional and HRQOL outcomes after CXB and (chemo)radiation using EORTC-QLQ-CR29, HADS, and EQ-5D-3L questionnaires. Longitudinal analyses were conducted using linear mixed-effects models, incorporating both fixed and random effects, following data processing based on relevant scoring manuals. QOL was assessed in 53 patients who attended our centre for CXB for various clinical indications, with 51, 47, and 42 remaining at the end of treatment, 6-month, and 12-month follow-ups, respectively. Overall, symptom and functional scores from EORTC-QLQ-CR29 remained stable throughout the follow-up period. Significant improvements were observed in abdominal pain, flatulence, urinary frequency, and body weight at 12 months. HADS and EQ-5D-3L scores remained stable, while EQ-VAS scores showed improvement, indicating a good overall quality of life following CXB treatment. CXB treatment combined with (chemo)radiation maintained stable HRQOL, with some improvements in symptoms and QOL noted during the subsequent year. These findings will help rectal cancer patients understand the benefits and limitations of CXB as a treatment option.
随着直肠癌治疗方法的最新进展使患者生存期延长，各种治疗方法对患者生活质量（QOL）的影响成为重要的关注焦点。虽然存在关于（化疗）放疗联合/不联合局部切除后观察等待的生活质量研究，但关于接触性X线近距离放射治疗（CXB）后健康相关生活质量（HRQOL）结果的数据仍然有限。本研究评估了接受CXB和（化疗）放疗一年以上的直肠癌患者的功能和HRQOL结果。这项前瞻性观察性研究（2023年1月至10月入组）进行了一年的随访，使用欧洲癌症研究与治疗组织生活质量问卷结直肠癌模块29（EORTC-QLQ-CR29）、医院焦虑抑郁量表（HADS）和欧洲五维度健康量表（EQ-5D-3L）问卷评估CXB和（化疗）放疗后的功能和HRQOL结果。在根据相关评分手册进行数据处理后，使用线性混合效应模型进行纵向分析，该模型纳入了固定效应和随机效应。对因各种临床指征到我们中心接受CXB治疗的53例患者进行了生活质量评估，分别有51例、47例和42例在治疗结束时、6个月和12个月随访时仍在参与研究。总体而言，EORTC-QLQ-CR29的症状和功能评分在整个随访期间保持稳定。在12个月时，腹痛、肠胃胀气、尿频和体重方面有显著改善。HADS和EQ-5D-3L评分保持稳定，而EQ-VAS评分有所改善，表明CXB治疗后总体生活质量良好。CXB治疗联合（化疗）放疗使HRQOL保持稳定，在随后的一年中症状和生活质量有一些改善。这些发现将有助于直肠癌患者了解CXB作为一种治疗选择的益处和局限性。
