Evaluation of toxicity and quality of life using a diary card during postoperative radiotherapy for rectal cancer.
OBJECTIVE
Adjuvant pelvic radiotherapy after radical surgery for rectal cancer may produce several side-effects (mainly gastrointestinal) capable of affecting patient lifestyle. This prospective study evaluated by means of a diary card the toxicity and daily changes in the quality of life of patients with rectal cancer treated with postoperative pelvic radiotherapy.


METHODS
We used a diary card listing ten items about lifestyle changes and side-effects compiled by patients themselves. The patients were stratified by age (< or = 65 vs. > 65 years), the presence or not of a stoma, and the administration or not of concurrent chemotherapy.


RESULTS
Twenty-seven patients were evaluable. The mean number of bowel movements increased across time, without statistically significant differences. Nausea and appetite did not significantly change during the treatment period. There was a statistically significant, progressive increase in the perception of pain (P < 0.03). Although not significantly, the anxiety scores were lower during radiotherapy than at baseline. Daily activities and compliance with therapy did not significantly change during the treatment. There was a significant worsening in overall well-being (P < 0.04) and quality of life evaluation (P < 0.03). The patients who received chemoradiotherapy experienced a worsened lifestyle and greater side-effects. Older patients experienced less pain but had statistically significant higher levels of anxiety. Patients with a stoma reported a better quality of life score than those without.


CONCLUSIONS
The use of a diary card may be an adequate means of detecting the extent of treatment-related changes in the lifestyle of patients with rectal cancer treated by postoperative radiotherapy.
Caffo
Orazio
O
Department of Medical Oncology, St. Chiara Hospital, Trento, Italy.
Amichetti
Maurizio
M
Romano
Mario
M
Maluta
Sergio
S
Tomio
Luigi
L
Galligioni
Enzo
E
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011182:Postoperative Care / Q000009:adverse effects*; D011446:Prospective Studies; D011788:Quality of Life; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D012004:Rectal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*