Patient-reported outcomes after chemoradiotherapy for anal cancer
Background and purpose: Chemoradiotherapy (CRT) for squamous cell carcinoma of the anus (SCCA) results in favorable survival. However, treatment intensity must be balanced against late side effects. The aim of this current study was to prospectively investigate patient-reported outcomes (PROs) befor...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Medical Journals Sweden
2025-07-01
|
| Series: | Acta Oncologica |
| Subjects: | |
| Online Access: | https://medicaljournalssweden.se/actaoncologica/article/view/43636 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1839609404771532800 |
|---|---|
| author | Kathinka Schmidt Slørdahl Eva Skovlund Jan-Åge Olsen Ragnhild Tvedt Maria Thomsen Stein Kaasa Marianne Grønlie Guren |
| author_facet | Kathinka Schmidt Slørdahl Eva Skovlund Jan-Åge Olsen Ragnhild Tvedt Maria Thomsen Stein Kaasa Marianne Grønlie Guren |
| author_sort | Kathinka Schmidt Slørdahl |
| collection | DOAJ |
| description | Background and purpose: Chemoradiotherapy (CRT) for squamous cell carcinoma of the anus (SCCA) results in favorable survival. However, treatment intensity must be balanced against late side effects. The aim of this current study was to prospectively investigate patient-reported outcomes (PROs) before CRT and up to 5 years after completed CRT for SCCA.
Patient/material and methods: This prospective study included 120 patients with SCCA receiving CRT to total doses of 54–58 Gy with concomitant mitomycin and 5-fluorouracil. Patients completed PRO questionnaires before CRT, and at 3 months, 1-, 3-, and 5 years after completed CRT. The questionnaires were the EORTC QLQ-C30 and QLQ-CR29, St. Marks incontinence score, Fatigue Questionnaire, the Hospital Anxiety and Depression Scale, and a scoring for neuroticism.
Results: Patients reported a high burden of symptoms and impaired functional outcomes prior to treatment. Tumor-related symptoms, such as buttock pain, improved (difference 11.1, p = 0.002) at a clinically relevant level 3 months after CRT, consistent with tumor response. Other functional outcomes and symptoms, such as body image (difference 11.5, p < 0.001), worsened. While some outcomes, such as anxiety (difference 10.4, p = 0.001), improved over time, several were persistently impaired, in particular anorectal and sexual function, where symptom burden remained high 5 years after CRT. Chronic fatigue (CF) was reported by 28% of patients at 5-year follow-up.
Interpretation: Five years after CRT for SCCA, patients report a persistently high symptom burden regarding anorectal and sexual function, and one-third report CF, demonstrating the long-term impact of treatment.
|
| format | Article |
| id | doaj-art-d7cc7c1c372c46c3ab0d3a6cd161dcb8 |
| institution | Matheson Library |
| issn | 1651-226X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Oncologica |
| spelling | doaj-art-d7cc7c1c372c46c3ab0d3a6cd161dcb82025-07-30T08:04:19ZengMedical Journals SwedenActa Oncologica1651-226X2025-07-016410.2340/1651-226X.2025.43636Patient-reported outcomes after chemoradiotherapy for anal cancerKathinka Schmidt Slørdahl0https://orcid.org/0000-0002-0538-4977Eva Skovlund1https://orcid.org/0000-0002-2997-6141Jan-Åge Olsen2https://orcid.org/0000-0003-4822-0101Ragnhild Tvedt3Maria Thomsen4Stein Kaasa5Marianne Grønlie Guren6Department of Oncology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayDepartment of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, NorwayDepartment of Oncology, Oslo University Hospital, Oslo, NorwayDepartment of Oncology, Oslo University Hospital, Oslo, NorwayDepartment of Oncology, Oslo University Hospital, Oslo, NorwayInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; European Palliative Care Research Centre (PRC), Department of Oncology, Oslo, NorwayDepartment of Oncology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayBackground and purpose: Chemoradiotherapy (CRT) for squamous cell carcinoma of the anus (SCCA) results in favorable survival. However, treatment intensity must be balanced against late side effects. The aim of this current study was to prospectively investigate patient-reported outcomes (PROs) before CRT and up to 5 years after completed CRT for SCCA. Patient/material and methods: This prospective study included 120 patients with SCCA receiving CRT to total doses of 54–58 Gy with concomitant mitomycin and 5-fluorouracil. Patients completed PRO questionnaires before CRT, and at 3 months, 1-, 3-, and 5 years after completed CRT. The questionnaires were the EORTC QLQ-C30 and QLQ-CR29, St. Marks incontinence score, Fatigue Questionnaire, the Hospital Anxiety and Depression Scale, and a scoring for neuroticism. Results: Patients reported a high burden of symptoms and impaired functional outcomes prior to treatment. Tumor-related symptoms, such as buttock pain, improved (difference 11.1, p = 0.002) at a clinically relevant level 3 months after CRT, consistent with tumor response. Other functional outcomes and symptoms, such as body image (difference 11.5, p < 0.001), worsened. While some outcomes, such as anxiety (difference 10.4, p = 0.001), improved over time, several were persistently impaired, in particular anorectal and sexual function, where symptom burden remained high 5 years after CRT. Chronic fatigue (CF) was reported by 28% of patients at 5-year follow-up. Interpretation: Five years after CRT for SCCA, patients report a persistently high symptom burden regarding anorectal and sexual function, and one-third report CF, demonstrating the long-term impact of treatment. https://medicaljournalssweden.se/actaoncologica/article/view/43636anal cancerchemoradiotherapypatient reported outcome measureschronic fatigueanorectal function |
| spellingShingle | Kathinka Schmidt Slørdahl Eva Skovlund Jan-Åge Olsen Ragnhild Tvedt Maria Thomsen Stein Kaasa Marianne Grønlie Guren Patient-reported outcomes after chemoradiotherapy for anal cancer Acta Oncologica anal cancer chemoradiotherapy patient reported outcome measures chronic fatigue anorectal function |
| title | Patient-reported outcomes after chemoradiotherapy for anal cancer |
| title_full | Patient-reported outcomes after chemoradiotherapy for anal cancer |
| title_fullStr | Patient-reported outcomes after chemoradiotherapy for anal cancer |
| title_full_unstemmed | Patient-reported outcomes after chemoradiotherapy for anal cancer |
| title_short | Patient-reported outcomes after chemoradiotherapy for anal cancer |
| title_sort | patient reported outcomes after chemoradiotherapy for anal cancer |
| topic | anal cancer chemoradiotherapy patient reported outcome measures chronic fatigue anorectal function |
| url | https://medicaljournalssweden.se/actaoncologica/article/view/43636 |
| work_keys_str_mv | AT kathinkaschmidtslørdahl patientreportedoutcomesafterchemoradiotherapyforanalcancer AT evaskovlund patientreportedoutcomesafterchemoradiotherapyforanalcancer AT janageolsen patientreportedoutcomesafterchemoradiotherapyforanalcancer AT ragnhildtvedt patientreportedoutcomesafterchemoradiotherapyforanalcancer AT mariathomsen patientreportedoutcomesafterchemoradiotherapyforanalcancer AT steinkaasa patientreportedoutcomesafterchemoradiotherapyforanalcancer AT mariannegrønlieguren patientreportedoutcomesafterchemoradiotherapyforanalcancer |