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Systematic review of the quality of life issues associated with anal cancer and its treatment with radiochemotherapy

Systematic review of the quality of life issues associated with anal cancer and its treatment with radiochemotherapy
Systematic review of the quality of life issues associated with anal cancer and its treatment with radiochemotherapy
Purpose: Radiochemotherapy is the standard of care for the treatment of anal carcinoma achieving good loco-regional control and sphincter preservation. This approach is however associated with acute and late toxicities including haematological, skin, bowel function and genito-urinary complications. This paper systematically reviews studies addressing the quality of life (QoL) implications of anal cancer and radiochemotherapy. The paper also evaluates how QoL is assessed in anal cancer.

Methods: Medline, EMBASE, CINAHL, PsycInfo, Web of Science and the Cochrane Library were searched for publications (1996–2014) reporting the effects on patients of anal cancer and radiochemotherapy.

Results: Of the 152 papers reporting treatment-related effects on patients, only 11 provided a formal assessment of QoL. In the absence of an anal cancer-specific measure, QoL was assessed using generic cancer instruments such as the core EORTC quality of life questionnaire (EORTC QLQ-C30) or colorectal cancer tools such as the EORTC QLQ-CR29. Bowel function, particularly diarrhoea, and sexual problems were the most commonly reported QoL concerns. The review of QoL issues of anal cancer patients treated with radiochemotherapy is limited by the QoL assessment measures used. It is argued that certain treatment-related toxicities, for example skin-induced radiation problems, are overlooked or inadequately represented in existing measures.

Conclusions: This review emphasises the need to develop an anal cancer-specific QoL measure and to incorporate QoL as an outcome of future trials in anal cancer. The results of this review are informative to clinicians and patients in terms of treatment decision-making.
anal cancer, radiochemotherapy, quality of life, toxicities
0941-4355
3613-3623
Sodergren, Samantha
d66fc3fa-2c98-403d-8ae5-410ef95de46e
Vassiliou, Vassilios
2f17223f-b322-4752-9f1b-f4bc7e4af047
Dennis, Kristopher
30b6e211-17c5-453d-9dd7-e4374fe92d14
Tomaszewski, Krzysztof A.
517bb086-c18b-4dc5-9029-bd3d0202b356
Gilbert, Alexandra
476e77d0-b308-4e71-9ec4-88704ac1d035
Glynne-Jones, Robert
3973d3d5-deaa-4170-b0db-e37ba2d7844e
Nugent, Karen
79fcb89d-6ff2-47b8-ac2c-2afb24954456
Sebag-Montefiore, David
7cd6f558-4265-4adb-b8dd-771f47ab8343
Johnson, Colin D.
e50aa9cd-8c61-4fe3-a0b3-f51cc3a6c74a
Sodergren, Samantha
d66fc3fa-2c98-403d-8ae5-410ef95de46e
Vassiliou, Vassilios
2f17223f-b322-4752-9f1b-f4bc7e4af047
Dennis, Kristopher
30b6e211-17c5-453d-9dd7-e4374fe92d14
Tomaszewski, Krzysztof A.
517bb086-c18b-4dc5-9029-bd3d0202b356
Gilbert, Alexandra
476e77d0-b308-4e71-9ec4-88704ac1d035
Glynne-Jones, Robert
3973d3d5-deaa-4170-b0db-e37ba2d7844e
Nugent, Karen
79fcb89d-6ff2-47b8-ac2c-2afb24954456
Sebag-Montefiore, David
7cd6f558-4265-4adb-b8dd-771f47ab8343
Johnson, Colin D.
e50aa9cd-8c61-4fe3-a0b3-f51cc3a6c74a

Sodergren, Samantha, Vassiliou, Vassilios, Dennis, Kristopher, Tomaszewski, Krzysztof A., Gilbert, Alexandra, Glynne-Jones, Robert, Nugent, Karen, Sebag-Montefiore, David and Johnson, Colin D. (2015) Systematic review of the quality of life issues associated with anal cancer and its treatment with radiochemotherapy. Supportive Care in Cancer, 23 (12), 3613-3623. (doi:10.1007/s00520-015-2879-2).

Record type: Article

Abstract

Purpose: Radiochemotherapy is the standard of care for the treatment of anal carcinoma achieving good loco-regional control and sphincter preservation. This approach is however associated with acute and late toxicities including haematological, skin, bowel function and genito-urinary complications. This paper systematically reviews studies addressing the quality of life (QoL) implications of anal cancer and radiochemotherapy. The paper also evaluates how QoL is assessed in anal cancer.

Methods: Medline, EMBASE, CINAHL, PsycInfo, Web of Science and the Cochrane Library were searched for publications (1996–2014) reporting the effects on patients of anal cancer and radiochemotherapy.

Results: Of the 152 papers reporting treatment-related effects on patients, only 11 provided a formal assessment of QoL. In the absence of an anal cancer-specific measure, QoL was assessed using generic cancer instruments such as the core EORTC quality of life questionnaire (EORTC QLQ-C30) or colorectal cancer tools such as the EORTC QLQ-CR29. Bowel function, particularly diarrhoea, and sexual problems were the most commonly reported QoL concerns. The review of QoL issues of anal cancer patients treated with radiochemotherapy is limited by the QoL assessment measures used. It is argued that certain treatment-related toxicities, for example skin-induced radiation problems, are overlooked or inadequately represented in existing measures.

Conclusions: This review emphasises the need to develop an anal cancer-specific QoL measure and to incorporate QoL as an outcome of future trials in anal cancer. The results of this review are informative to clinicians and patients in terms of treatment decision-making.

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More information

Accepted/In Press date: 29 July 2015
e-pub ahead of print date: 20 August 2015
Published date: December 2015
Keywords: anal cancer, radiochemotherapy, quality of life, toxicities
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 385277
URI: http://eprints.soton.ac.uk/id/eprint/385277
ISSN: 0941-4355
PURE UUID: e3d21a3f-f2a6-425b-bafc-f2d75cfe8a3e
ORCID for Samantha Sodergren: ORCID iD orcid.org/0000-0001-8755-146X

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Date deposited: 18 Jan 2016 15:11
Last modified: 15 Mar 2024 03:45

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Contributors

Author: Vassilios Vassiliou
Author: Kristopher Dennis
Author: Krzysztof A. Tomaszewski
Author: Alexandra Gilbert
Author: Robert Glynne-Jones
Author: Karen Nugent
Author: David Sebag-Montefiore

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