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document
Late patient-reported toxicity after preoperative radiotherapy or chemoradiotherapy in nonresectable rectal cancer : results from a randomized Phase III study . PURPOSE Preoperative chemoradiotherapy ( CRT ) is superior to radiotherapy ( RT ) in locally advanced rectal cancer , but the survival gain is limited . Late toxicity is , therefore , important . The aim was to compare late bowel , urinary , and sexual functions after CRT or RT . METHODS AND MATERIALS Patients ( N = 207 ) with nonresectable rectal cancer were randomized to preoperative CRT or RT ( 2 Gy × 25 ± 5-fluorouracil/leucovorin ) . Extended surgery was often required . Self-reported late toxicity was scored according to the LENT SOMA criteria in a structured telephone interview and with questionnaires European Organisation for Research and Treatment of Cancer ( EORTC ) Quality of Life Questionnaire ( QLQ-C30 ) , International Index of Erectile Function ( IIEF ) , and sexual function-vaginal changes questionnaire ( SVQ ) . RESULTS Of the 105 patients alive in Norway and Sweden after 4 to 12 years of follow-up , 78 ( 74 % ) responded . More patients in the CRT group had received a stoma ( 73 % vs. 52 % , p = 0.09 ) . Most patients without a stoma ( 7 of 12 in CRT group and 9 of 16 in RT group ) had incontinence for liquid stools or gas . No stoma and good anal function were seen in 5 patients ( 11 % ) in the CRT group and in 11 ( 30 % ) in the RT group ( p = 0.046 ) . Of 44 patients in the CRT group , 12 ( 28 % ) had had bowel obstruction compared with 5 of 33 ( 15 % ) in the RT group ( p = 0.27 ) . One-quarter of the patients reported urinary incontinence . The majority of men had severe erectile dysfunction . Few women reported sexual activity during the previous month . However , the majority did not have concerns about their sex life . CONCLUSIONS Fecal incontinence and erectile dysfunction are frequent after combined treatment for locally advanced rectal cancer . There was a clear tendency for the problems to be more common after CRT than after RT .
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Intervention_Physical
radiotherapy
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Intervention_Physical
chemoradiotherapy
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Intervention_Physical
Preoperative chemoradiotherapy
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Intervention_Physical
radiotherapy
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Intervention_Surgical
preoperative CRT
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Intervention_Surgical
RT
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Outcome_Mortality
survival gain
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Outcome_Adverse-effects
toxicity
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Outcome_Physical
late bowel , urinary
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Outcome_Physical
sexual functions
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Participant_Condition
nonresectable rectal cancer
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Participant_Condition
locally advanced rectal cancer
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Participant_Sample-size
207
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Participant_Condition
nonresectable rectal cancer
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Participant_Sample-size
105