Impact of Preoperative Radiotherapy on General and Disease-Specific Health Status of Rectal Cancer Survivors: A Population-Based Study

• Published in: International journal of radiation oncology, biology, physics Vol. 81; no. 3; pp. e49 - e58
• Main Authors: Thong, Melissa S.Y., Ph.D, Mols, Floortje, Ph.D, Lemmens, Valery E.P.P., Ph.D, Rutten, Harm J.T., M.D., Ph.D, Roukema, Jan A., M.D., Ph.D, Martijn, Hendrik, M.D., Ph.D, van de Poll-Franse, Lonneke V., Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2011
• Subjects: Age Factors; Aged; Algorithms; BODY; Body Image; Defecation - physiology; Defecation - radiation effects; DIAGNOSIS; DIGESTIVE SYSTEM; DISEASE INCIDENCE; DISEASES; Female; GASTROINTESTINAL TRACT; Health Status; Health-related quality of life; Hematology, Oncology and Palliative Medicine; Humans; INTESTINES; LARGE INTESTINE; Male; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; Preoperative Care - methods; Preoperative radiotherapy; Quality of Life; RADIOLOGY; RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; Rectal cancer; Rectal Neoplasms - pathology; Rectal Neoplasms - psychology; Rectal Neoplasms - radiotherapy; Rectal Neoplasms - surgery; RECTUM; Regression Analysis; SEX; Sexual Dysfunctions, Psychological - etiology; Socioeconomic Factors; STANDARD OF LIVING; SURGERY; Surveys and Questionnaires; Survivors; SYMPTOMS; THERAPY; Preoperative radiotherapy; Health-related quality of life; Rectal cancer; Symptoms; Survivors
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/j.ijrobp.2010.12.030

Purpose To date, few studies have evaluated the impact of preoperative radiotherapy (pRT) on long-term health status of rectal cancer survivors. Using a population-based sample, we assessed the impact of pRT on general and disease-specific health status of rectal cancer survivors up to 10 years postdiagnosis. The health status of older (≥75 years old at diagnosis) pRT survivors was also compared with that of younger survivors. Methods and Materials Survivors identified from the Eindhoven Cancer Registry treated with surgery only (SU) or with pRT between 1998 and 2007 were included. Survivors completed the Short Form-36 (SF-36) health survey questionnaire and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Colorectal 38 (EORTC QLQ-CR38) questionnaire. The SF-36 and EORTC QLQ-CR38 (sexuality subscale) scores of the survivors were compared to an age- and sex-matched Dutch normal population. Results A total of 340 survivors (response, 85%; pRT survivors, 71%) were analyzed. Overall, survivors had similar general health status. Both short-term (<5 years) and long-term (≥5 years) pRT survivors had significantly poorer body image and more problems with gastrointestinal function, male sexual dysfunction, and defecation than SU survivors. Survivors had comparable general health status but greater sexual dysfunction than the normal population. Older pRT survivors had general and disease-specific health status comparable to that of younger pRT survivors. Conclusions For better survivorship care, rectal cancer survivors could benefit from increased clinical and psychological focus on the possible long-term morbidity of treatment and its effects on health status.