title: Palliative pelvic radiotherapy for symptomatic rectal cancer - a prospective multicenter study.
abstract: OBJECTIVE
  Palliative pelvic radiotherapy (PPRT) is used to treat locally advanced rectal cancer (RC) although symptomatic effects and toxicities are poorly documented. Aims were to evaluate symptom severity, quality of life (QOL) and toxicity after PPRT.
  
  
  METHODS
  Fifty-one patients with symptomatic primary or recurrent RC prescribed PPRT with fractions of 3 Gy to 30-39 Gy were included. Primary outcome was severity of target symptoms (TS) 12 weeks after PPRT. Pelvic symptom burden, toxicity, and QOL were assessed. Response was defined as patient-reported TS improvement or resolution.
  
  
  RESULTS
  Pain (n = 24), rectal dysfunction (n = 16), and hematochezia (n = 9) were the most common TSs. Overall response rate among evaluable patients 12 weeks after PPRT was 28/33 (85%). Eighteen patients did not complete the study follow-up, 16 due to deteriorating health. TS responses were 10/13 (77%) for pain, 9/10 (90%) for rectal dysfunction, and 8/8 for hematochezia. Non-target pelvic symptom severity decreased and median QOL scores remained stable. There was no grade 4 toxicity. Median survival was nine months.
  
  
  CONCLUSIONS
  In the majority of patients with symptomatic primary or recurrent RC, PPRT with 30-39 Gy contributes to pelvic symptom relief, with little toxicity. Patients prescribed PPRT of RC have limited life expectancy. Future studies should investigate simplification of PPRT.
authors.affiliation: a Center for Cancer Treatment, Sørlandet Hospital , Kristiansand , Norway.
authors.forename: Marte G
authors.initials: MG
authors.lastname: Cameron
authors.affiliation: a Center for Cancer Treatment, Sørlandet Hospital , Kristiansand , Norway.
authors.forename: Christian
authors.initials: C
authors.lastname: Kersten
authors.affiliation: b Department of Obstetrics and Gynecology, Sørlandet Hospital , Kristiansand , Norway.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Vistad
authors.affiliation: a Center for Cancer Treatment, Sørlandet Hospital , Kristiansand , Norway.
authors.forename: Rene
authors.initials: R
authors.lastname: van Helvoirt
authors.affiliation: c Department of Oncology , Innlandet Hospital , Gjøvik , Norway.
authors.forename: Kjetil
authors.initials: K
authors.lastname: Weyde
authors.affiliation: d Department of Oncology, Oslo University Hospital , Oslo , Norway.
authors.forename: Christine
authors.initials: C
authors.lastname: Undseth
authors.affiliation: e Department of Oncology , Stavanger University Hospital , Stavanger , Norway.
authors.forename: Ingvil
authors.initials: I
authors.lastname: Mjaaland
authors.affiliation: f Department of Public Health and General Practice , Norwegian University of Science and Technology, Trondheim and the Norwegian Institute of Public Health , Oslo , Norway.
authors.forename: Eva
authors.initials: E
authors.lastname: Skovlund
authors.affiliation: d Department of Oncology, Oslo University Hospital , Oslo , Norway.
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
authors.affiliation: d Department of Oncology, Oslo University Hospital , Oslo , Norway.|g K. G. Jebsen Colorectal Cancer Research Centre , Oslo University Hospital , Oslo , Norway.
authors.forename: Marianne G
authors.initials: MG
authors.lastname: Guren
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010166:Palliative Care; D010386:Pelvic Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D012720:Severity of Illness Index; D015996:Survival Rate