Patient-Reported Outcomes After Neoadjuvant Chemoradiotherapy for Rectal Cancer

In Brief Objective: To prospectively describe patient-reported outcomes (PROs) after preoperative chemoradiotherapy (pCRT) for rectal cancer. Background: Little evidence is available on PROs after pCRT for rectal cancer. Patients and Methods: Patients with rectal cancer, candidates to receive pCRT, were enrolled in a multicenter prospective observational trial. Health-related quality of life was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and its colorectal cancer module (QLQ-CR38), and fecal incontinence and bowel function were evaluated using the fecal incontinence score questionnaire and a set of ad hoc questions. Questionnaires were filled out before CRT (t0), 2 to 3 weeks after completion of CRT (t1), and at 6 (t2) and 12 months (t3) after surgery. Primary analysis of selected scales included: global quality of life, physical functioning, social functioning, fatigue, body image, future prospective, and gender-related sexual problems. Results: Of 149 eligible patients, questionnaires were completed in 100%, 95%, 88% and 77% of cases at t0, t1, t2, and t3, respectively. At t3, 78% of patients reported stool fractionation and 72% sensation of incomplete defecation. Only 14% of patients had optimal continence. Physical/social functioning, fatigue, and body image showed a decrease just after pCRT and returned to baseline levels at 1 year after treatment. Global quality of life was stable over time. Male sexual problems were greatly impaired throughout the study period (P < 0.001) with major clinically meaningful changes between baseline and 1 year after treatment. Conclusions: These findings add to the body of evidence available regarding pCRT and help clinicians to make more informed treatment decisions. Patient-reported outcomes were assessed, in a prospective multicenter study including 149 patients who underwent preoperative chemoradiotherapy (pCRT) for rectal cancer. Bowel function, fecal continence and male sexual problems were the mostly affected health status areas over the one year period after surgery. Global quality of life however remained stable over time.