A modified inflammatory bowel disease questionnaire and the Vaizey Incontinence questionnaire are more sensitive measures of acute gastrointestinal toxicity during pelvic radiotherapy than RTOG grading.
OBJECTIVE
Simple scales with greater sensitivity than Radiation Therapy Oncology Group (RTOG) grading to detect acute gastrointestinal toxicity during pelvic radiotherapy, could be clinically useful.


METHODS
Do questionnaires used in benign gastrointestinal diseases detect toxicity in patients undergoing radiotherapy? The patient-completed Inflammatory Bowel Disease (IBDQ) and Vaizey Incontinence questionnaires were compared prospectively at baseline and at Week 5 to physician-completed RTOG grading.


RESULTS
A total of 107 patients, median age 63 years, were recruited. After 5 weeks of treatment, patients with gynecologic and gastrointestinal cancer were more symptomatic than urologic patients (p = 0.012; p = 0.014). Overall, 94% had altered bowel habits, 80% loose stool, 74% frequency, 65% difficult gas, 60% pain, >48% distress, 44% tenesmus, >40% restrictions in daily activity, 39% urgency, 37% fecal incontinence, and 40% required antidiarrheal medication. The median RTOG score was 1 (range, 0-2), median IBDQ score 204.5 (range, 74-224), and median Vaizey score 5 (range, 0-20). Chemotherapy preceding radiotherapy increased fecal incontinence (p = 0.002). RTOG scores stabilized after 3 weeks, IBDQ scores peaked at Week 4, and Vaizey scores worsened throughout treatment. IBDQ and Vaizey scores distinguished between groups with different RTOG scores.


CONCLUSIONS
The IBDQ and Vaizey questionnaires are reliable and sensitive, offering greater insight into the severity and range of symptoms compared with RTOG grading.
Department of Medicine, The Royal Marsden Hospital, London and Surrey, UK.
Usman
U
Khalid
Camilla
C
McGough
Claire
C
Hackett
Peter
P
Blake
Kevin J
KJ
Harrington
Vincent S
VS
Khoo
Diana
D
Tait
Andrew R
AR
Norman
H Jervoise N
HJ
Andreyev
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000532:radiotherapy*; D041981:Gastrointestinal Tract / Q000528:radiation effects*; D005833:Genital Neoplasms, Female / Q000532:radiotherapy*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D018787:Radiation Oncology / Q000592:standards; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D014571:Urologic Neoplasms / Q000532:radiotherapy*