International Journal of Radiation Oncology * Biology * Physics
Volume 76, Issue 4 , Pages 1005-1011 , 15 March 2010

Late Side Effects and Quality of Life After Radiotherapy for Rectal Cancer

  • Kjersti Bruheim, M.D.

      Affiliations

    • The Cancer Centre, Oslo University Hospital, Ullevål, Oslo, Norway
    • Corresponding Author InformationReprint requests to: Kjersti Bruheim, MD., The Cancer Centre, Oslo University Hospital, Ullevål, 0407, Oslo, Norway. Telephone: +47-23 02 66 00; Fax: +47-23 02 66 01
    • ,
  • Marianne G. Guren, M.D., Ph.D.

      Affiliations

    • The Cancer Centre, Oslo University Hospital, Ullevål, Oslo, Norway
    • ,
  • Eva Skovlund, Ph.D.

      Affiliations

    • School of Pharmacy, University of Oslo, Oslo, Norway
    • ,
  • Marianne J. Hjermstad, Ph.D.

      Affiliations

    • The Cancer Centre, Oslo University Hospital, Ullevål, Oslo, Norway
    • Pain and Palliation Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
    • ,
  • Olav Dahl, M.D., Ph.D.

      Affiliations

    • Section of Oncology, Institute of Medicine and Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
    • ,
  • Gunilla Frykholm, M.D., Ph.D.

      Affiliations

    • Department of Oncology, St Olavs Hospital, Trondheim, Norway
    • ,
  • Erik Carlsen, M.D., Ph.D.

      Affiliations

    • Department of Gastrointestinal Surgery, Oslo University Hospital, Ullevål, Oslo, Norway
    • ,
  • Kjell Magne Tveit, M.D., Ph.D.

      Affiliations

    • The Cancer Centre, Oslo University Hospital, Ullevål, Oslo, Norway
    • Faculty of Medicine, University of Oslo, Oslo, Norway

Received 25 November 2008 ,Revised 24 February 2009 ,Accepted 5 March 2009.

References 

  1. Heald RJ, Ryall RDH. Recurrence and survival after total mesorectal exicion for rectal cancer. Lancet. 1986;327:1479–1482
  2. Wibe A, Carlsen E, Dahl O, et al. Nationwide quality assurance of rectal cancer treatment. Colorectal Dis. 2006;8:224–229
  3. Peeters KC, Marijnen CA, Nagtegaal ID, et al. The TME trial after a median follow-up of 6 years: Increased local control but no survival benefit in radiation-treated patients with resectable rectal carcinoma. Ann Surg. 2007;246:693–701
  4. Hansen MH, Kjaeve J, Revhaug A, et al. Impact of radiotherapy on local recurrence of rectal cancer in Norway. Br J Surg. 2007;94:113–118
  5. Marijnen CA, van de Velde CJH, Putter H, et al. Impact of short-term preoperative radiotherapy on health-related quality of life and sexual functioning in primary rectal cancer: Report of a multicenter randomized trial. J Clin Oncol. 2005;23:1847–1858
  6. Pietrzak L, Bujko K, Nowacki MP, et al. Quality of life, anorectal and sexual functions after preoperative radiotherapy for rectal cancer: Report of a randomised trial. Radiother Oncol. 2007;84:217–225
  7. Peeters KC, van de Velde CJH, Leer JW, et al. Late side effects of short-course preoperative radiotherapy combined with total mesorectal excision for rectal cancer: Increased bowel dysfunction in radiation-treated patients—a Dutch colorectal cancer group study. J Clin Oncol. 2005;23:6199–6206
  8. Bujko K, Nowacki MP, Nasierowska-Guttmejer A, et al. Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg. 2006;93:1215–1223
  9. Birgisson H, Pahlman L, Gunnarsson U, et al. Late adverse effects of radiation therapy for rectal cancer—a systematic overview. Acta Oncol. 2007;46:504–516
  10. Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351:1731–1740
  11. Lundby L, Krogh K, Jensen VJ, et al. Long-term anorectal dysfunction after postoperative radiotherapy for rectal cancer. Dis Colon Rectum. 2005;48:1343–1349
  12. Pietsch AP, Fietkau R, Klautke G, et al. Effect of neoadjuvant chemoradiation on postoperative fecal continence and anal sphincter function in rectal cancer patients. Int J Colorectal Dis. 2007;22:1311–1317
  13. Gervaz P, Rotholtz N, Wexner SD, et al. Colonic J-pouch function in rectal cancer patients: Impact of adjuvant chemoradiotherapy. Dis Colon Rectum. 2001;44:1667–1675
  14. Guren MG, Eriksen MT, Wiig JN, et al. Quality of life and functional outcome following anterior or abdominoperineal resection for rectal cancer. Eur J Surg Oncol. 2005;31:735–742
  15. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–376
  16. Tveit KM, Guldvog I, Hagen S, et al. Randomized controlled trial of postoperative radiotherapy and short-term time-scheduled 5-fluorouracil against surgery alone in the treatment of Dukes B and C rectal cancer. Norwegian Adjuvant Rectal Cancer Project Group. Br J Surg. 1997;84:1130–1135
  17. Braendengen M, Tveit KM, Berglund A, et al. Randomized phase III study comparing preoperative radiotherapy with chemoradiotherapy in nonresectable rectal cancer. J Clin Oncol. 2008;26:3687–3694
  18. Vaizey CJ, Carapeti E, Cahill JA, et al. Prospective comparison of faecal incontinence grading systems. Gut. 1999;44:77–80
  19. LENT SOMA scales for all anatomic sites. Int J Radiat Oncol Biol Phys. 1995;31:1049–1091
  20. European Organisation for Research and Treatment of Cancer group for research into Quality of Life. http://groups.eortc.be/qol/.
  21. Hjermstad MJ, Fayers PM, Bjordal K, et al. Health-related quality of life in the general Norwegian population assessed by the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire: The QLQ=C30 (+ 3). J Clin Oncol. 1998;16:1188–1196
  22. Osoba D, Rodrigues G, Myles J, et al. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol. 1998;16:139–144
  23. Bruheim K, Svartberg J, Carlsen E, et al. Radiotherapy for rectal cancer is associated with reduced serum testosterone and increased FSH and LH. Int J Radiat Oncol Biol Phys. 2008;70:722–727
  24. Pollack J, Holm T, Cedermark B, et al. Late adverse effects of short-course preoperative radiotherapy in rectal cancer. Br J Surg. 2006;93:1519–1525
  25. Pollack J, Holm T, Cedermark B, et al. Long-term effect of preoperative radiation therapy on anorectal function. Dis Colon Rectum. 2006;49:345–352
  26. Dahlberg M, Glimelius B, Graf W, et al. Preoperative irradiation affects functional results after surgery for rectal cancer: Results from a randomized study. Dis Colon Rectum. 1998;41:543–549
  27. Fucini C, Gattai R, Urena C, et al. Quality of life among five-year survivors after treatment for very low rectal cancer with or without a permanent abdominal stoma. Ann Surg Oncol. 2008;15:1099–1106
  28. Engel J, Kerr J, Schlesinger-Raab A, et al. Quality of life in rectal cancer patients: A four-year prospective study. Ann Surg. 2003;238:203–213
  29. Cornish JA, Tilney HS, Heriot AG, et al. A meta-analysis of quality of life for abdominoperineal excision of rectum versus anterior resection for rectal cancer. Ann Surg Oncol. 2007;14:2056–2068
  30. Letschert JG, Lebesque JV, Aleman BM, et al. The volume effect in radiation-related late small bowel complications: Results of a clinical study of the EORTC Radiotherapy Cooperative Group in patients treated for rectal carcinoma. Radiother Oncol. 1994;32:116–123
  31. Al-Abany M, Helgason AR, Cronqvist AK, et al. Toward a definition of a threshold for harmless doses to the anal-sphincter region and the rectum. Int J Radiat Oncol Biol Phys. 2005;61:1035–1044
  32. Guerrero Urbano MT, Henrys AJ, Adams EJ, et al. Intensity-modulated radiotherapy in patients with locally advanced rectal cancer reduces volume of bowel treated to high dose levels. Int J Radiat Oncol Biol Phys. 2006;65:907–916
  33. Putta S, Andreyev HJ. Faecal incontinence: A late side-effect of pelvic radiotherapy. Clin Oncol (R Coll Radiol). 2005;17:469–477

 Conflict of interest: none.

PII: S0360-3016(09)00426-X

doi: 10.1016/j.ijrobp.2009.03.010

International Journal of Radiation Oncology * Biology * Physics
Volume 76, Issue 4 , Pages 1005-1011 , 15 March 2010

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