title: Patient reported quality of life after helical IMRT based concurrent chemoradiation of locally advanced anal cancer.
abstract: Concurrent chemoradiation (CCRT) is the standard treatment for locally advanced anal canal carcinoma, although treatment-related side effects can affect patient quality of life (QOL). The purpose was to prospectively evaluate the effects of Tomotherapy (HT) based CCRT on patient reported QOL in locally advanced anal cancer.
  
  
  
  Fifty-four patients treated with HT and concurrent 5-fluorouracil/mitomycin-C underwent QOL evaluation at baseline, after treatment, and during follow-up with EORTC core (QLQ-C30) and colorectal (QLQ-CR29) questionnaires. The QOL scores at baseline and post-treatment were compared.
  
  
  
  All C30 functional symptoms, except emotional and cognitive functioning, were impaired end-of-treatment and recovered by 3months follow-up. The majority of symptom scores were worse end-of-treatment but recovered by 3months except for fecal incontinence (FI), diarrhea, urinary incontinence (UI), and dyspareunia which persisted. FI returned to baseline at 12months while diarrhea, UI, and dyspareunia persisted.
  
  
  
  Most impaired functions and symptoms following HT based CCRT were temporary and improved by 3months post-therapy. Late complications affecting QOL were FI, sexual function, UI, and diarrhea. Our observations support routine use of IMRT and emphasize the significance of precise evaluation of sexual, urinary, and anorectal functions before starting CCRT and routine incorporation of QOL evaluations.
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada. Electronic address: kurian.joseph@albertahealthservices.ca.
authors.forename: Kurian
authors.initials: K
authors.lastname: Joseph
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Larissa J
authors.initials: LJ
authors.lastname: Vos
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Warkentin
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Kim
authors.initials: K
authors.lastname: Paulson
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Lee-Anne
authors.initials: LA
authors.lastname: Polkosnik
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Nawaid
authors.initials: N
authors.lastname: Usmani
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Keith
authors.initials: K
authors.lastname: Tankel
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Diane
authors.initials: D
authors.lastname: Severin
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Tirath
authors.initials: T
authors.lastname: Nijjar
authors.affiliation: Department of Surgical Oncology, University of Alberta & Alberta Health Services, Edmonton, Canada.
authors.forename: Dan
authors.initials: D
authors.lastname: Schiller
authors.affiliation: Department of Internal Gastroenterology, Royal Alexandra Hospital, Edmonton, Canada.
authors.forename: Clarence
authors.initials: C
authors.lastname: Wong
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Sunita
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Mulder
authors.affiliation: Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
authors.forename: Colin
authors.initials: C
authors.lastname: Field
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000534:rehabilitation* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation* / Q000628:therapy; D059248:Chemoradiotherapy / Q000009:adverse effects*; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D011594:Psychometrics; D011788:Quality of Life; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects* / Q000379:methods; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology
chemical_list: D016685:Mitomycin; D005472:Fluorouracil
keywords: Anal cancer; Helical Tomotherapy; Intensity-modulated radiation therapy (IMRT); Quality of life