title: Development and validation of a scoring system for late anorectal side-effects in patients treated with radiotherapy for prostate cancer.
abstract: OBJECTIVE
  To develop and validate a scoring system for evaluation of long term anorectal dysfunction following radiotherapy for prostate cancer.
  
  
  METHODS
  Patients treated for prostate cancer with radiotherapy filled in questionnaires on anorectal function and quality of life. Items for the condensed anorectal dysfunction score (RT-ARD) were identified and weighted by binomial regression analysis. The score was tested in a separate patient material by receiver operating characteristic (ROC) analysis and correlations to quality of life domains.
  
  
  RESULTS
  A total of 309 patients participated in the study. The items selected were "incontinence for solid stool", "ability to defer defecation", "unproductive call to stool", "clustering of stool", and "mucus in stool." Patients were grouped into three categories according to the RT-ARD score; 0-8 (no RT-ARD), 9-23 (minor RT-ARD), 24-45 (major RT-ARD). ROC analyses revealed high sensitivity (91%) and specificity (85%) for major RT-ARD. The prediction model demonstrated a perfect fit in 60%, moderate fit in 36% and no fit in 4%. There was good correlation between the RT-ARD score and quality of life.
  
  
  CONCLUSIONS
  The RT-ARD score is a validated and simple instrument for evaluation of anorectal dysfunction following radiotherapy for prostate cancer, and the RT-ARD score correlates to the patient's quality of life.
authors.affiliation: Department of Oncology, Aarhus University Hospital, Denmark. Electronic address: stine@oncology.dk.
authors.forename: Stine Elleberg
authors.initials: SE
authors.lastname: Petersen
authors.affiliation: Department of Oncology, Aarhus University Hospital, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Bentzen
authors.affiliation: Department of Surgery P, Aarhus University Hospital, Denmark.
authors.forename: Katrine J
authors.initials: KJ
authors.lastname: Emmertsen
authors.affiliation: Department of Surgery P, Aarhus University Hospital, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Laurberg
authors.affiliation: Department of Surgery P, Aarhus University Hospital, Denmark.
authors.forename: Lilli
authors.initials: L
authors.lastname: Lundby
authors.affiliation: Department of Oncology, Aarhus University Hospital, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Høyer
mesh_terms: D000368:Aged; D003672:Defecation / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D011788:Quality of Life; D011832:Radiation Injuries / Q000175:diagnosis* / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects; D012007:Rectum / Q000503:physiopathology / Q000528:radiation effects*; D012044:Regression Analysis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Late morbidity; Prostate cancer; Quality of life; Radiotherapy