Impact of short-course radiotherapy and low anterior resection on quality of life and bowel function in primary rectal cancer.
BACKGROUND
Short-course preoperative radiotherapy and total mesorectal excision have decreased local recurrence rates from rectal cancer. However, the effect of this radiotherapy on bowel function and quality of life in these patients is not well understood.


METHODS
Between 1999 and 2004, 34 patients underwent low anterior resection and either short-course preoperative radiation (N = 24) or surgery alone (N = 10). Quality of life and bowel function were assessed using validated instruments: European Organization of Research and Treatment of Cancer Quality of Life questionnaires, Fecal Incontinence Quality of Life Scale, and the Memorial Sloan-Kettering Cancer Center Bowel Function Instrument.


RESULTS
Patients treated with preoperative radiation had higher rates of fecal incontinence and showed a strong trend toward lower global quality-of-life scores. In addition, there was a trend toward worse bowel function in these patients.


CONCLUSIONS
Patients treated with short-course preoperative radiotherapy had worse continence-related quality of life than patients treated with surgery alone for rectal cancer. Fecal incontinence has a negative effect on quality of life in these patients, causing difficulty with coping, lifestyle, and depression, and limiting daily activities. Validated instruments provide standardized assessment of bowel function and quality of life.
Murata
Ariana
A
Division of General Surgery, University of British Columbia, St. Paul's Hospital, 1081 Burrard St., Vancouver, British Columbia, Canada V6Z 1Y6.
Brown
Carl J
CJ
Raval
Manoj
M
Phang
P Terry
PT
D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D039021:Colonic Pouches; D003131:Combined Modality Therapy; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007420:Intestine, Large / Q000528:radiation effects*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D010865:Pilot Projects; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires