Quality of life, anorectal and sexual functions after preoperative radiotherapy for rectal cancer: report of a randomised trial.
OBJECTIVE
Patients (N=316) with resectable cT3-4 low-lying and mid-rectal cancer were randomised to receive either preoperative 5x5Gy irradiation with subsequent surgery performed within 7 days or chemoradiation (50.4, 1.8Gy per fraction plus boluses of 5-fluorouracil and leucovorin) followed by surgery after 4-6 weeks. No differences were found in sphincter preservation, survival, local control and late complications. Early complications were less frequent in the short-course group. The aim of this report is to find out whether large doses per fraction of short-course schedule result in more severe anorectal and sexual dysfunction and quality of life (QoL) impairment.


METHODS
Patients who were free of disease were asked to answer the QLQ-C30 and those without stoma were, additionally, asked to fill in a questionnaire of anorectal (19 items) and sexual function (1 item).


RESULTS
Two hundred and twenty-two patients (86% response rate) completed the QLQ-C30 and 118 (86% response rate) the anorectal-sexual function questionnaire. The median time from surgery to filling in the QLQ-C30 questionnaire was 12 months, and to filling in the anorectal-sexual function questionnaire - 13 months. We did not find significant differences between the randomised groups regarding QoL and the anorectal and sexual functions. Approximately two-thirds of patients had anorectal function impairment. Approximately 20% of patients stated that this considerably influenced their QoL.


CONCLUSIONS
QoL and the anorectal and sexual functioning did not differ in patients receiving short-course radiotherapy, as compared to those receiving chemoradiation.
Pietrzak
Lucyna
L
Department of Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland.
Bujko
Krzysztof
K
Nowacki
Marek P
MP
Kepka
Lucyna
L
Oledzki
Janusz
J
Rutkowski
Andrzej
A
Szmeja
Jacek
J
Kladny
Jozef
J
Dymecki
Dariusz
D
Wieczorek
Andrzej
A
Pawlak
Mariusz
M
Lesniak
Tadeusz
T
Kowalska
Teresa
T
Richter
Piotr
P
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D012004:Rectal Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D012007:Rectum / Q000502:physiology*; D012725:Sexual Behavior; D011795:Surveys and Questionnaires