title: Quality of life outcomes in patients with anal cancer after combined radiochemotherapy.
abstract: OBJECTIVE
  To assess self-reported quality of life (QoL) experienced by anal cancer patients after radiochemotherapy, and to identify patient- and disease-related factors associated with QoL.
  
  
  METHODS
  A total of 88 patients treated for anal cancer at our institution between 1990 and 2006 were identified from our database. Of these, 15 patients had died, and 4 were lost to follow-up. QoL was assessed using the EORTC QLQ-C30 questionnaire (cancer-specific QoL) and the colorectal cancer module QLQ-CR38 (site-specific QoL); 52 responses were received. The median follow-up was 36 months (range, 5-137 months).
  
  
  RESULTS
  As for cancer-specific QoL, global health QoL score (mean 60.4) was similar to the general German population, whereas most of the function and symptom scale scores were considerably lower/higher in anal cancer patients. The most prominent mean score differences were observed in role functioning (-21.8 points), emotional functioning (-20.7 points), social functioning (-28.9 points), diarrhea (+34.6 points), and financial difficulties (+26.9 points; p < 0.001). As for site-specific QoL, the mean function scale scores ranged from 22.1 (sexual function) to 63.2 (body image), and the mean symptom scale scores from 14.7 (weight loss) to 69.0 (stoma-related problems, 4 patients) and 67.9 (male sexual dysfunction), respectively. Most of the QoL scores were not affected by late toxicity, patient- or disease-related factors. Fatigue (+18.2 points) emerged as the strongest predictor of impaired QoL.
  
  
  CONCLUSIONS
  The global health QoL of anal cancer patients is comparable with that of the general German population, but there are specific limitations, e.g., sexual dysfunction, urological/gastrointestinal complaints, financial difficulties, fatigue, and a reduction in emotional and social well-being.
authors.affiliation: Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Germany. grit.welzel@umm.de
authors.forename: Grit
authors.initials: G
authors.lastname: Welzel
authors.forename: Verena
authors.initials: V
authors.lastname: Hägele
authors.forename: Frederik
authors.initials: F
authors.lastname: Wenz
authors.forename: Sabine Kathrin
authors.initials: SK
authors.lastname: Mai
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy / Q000523:psychology*; D005221:Fatigue / Q000523:psychology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005858:Germany; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology*; D011832:Radiation Injuries / Q000523:psychology; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D005472:Fluorouracil