Impact of Adjuvant Chemoradiotherapy for Rectal Cancer on the Long-Term Quality of Life and Late Side Effects: A Multicentric Clinical Evaluation by the Turkish Oncology Group


Aim: Although preoperative chemoradiatherapy (CRT) has proven its benefits in terms of decreased toxicity,there is still a considerable amount of cases that do not receive postoperative CRT. Oncologists at differentgeographic locations still need to know the long-term effects of this treatment in order to manage patientssuccessfully. The current paper reports on long-term quality of life (QOL) and late side effects after adjuvant CRTin rectal cancer patients from 5 centers in Anatolia.
Methods: Rectal cancer patients treated with postoperativeCRT with minimum 1-year follow-up and were in complete remission, were evaluated according to RTOG andLENT-SOMA scales. They were also asked to complete Turkish version of EORTC QLQ-C30 questionnaire andthe CR-38 module. Each center participated with the required clinical data.
Results: Two hundred and thirtypatients with median age of 55 years participated and completed the study. Median follow-up time was 5 years.All patients received RT concomitant with chemotherapy. Common parameters that both increased functionalhealth scales and yielded better symptom scores were long term interval after treatment and sphincter-savingsurgery. In addition, surgery type and follow-up time were determined to be predictors of QOL scores and latetoxicity grade.
Conclusion: Postoperative CRT was found to have a great impact on the long term QOL and sideeffects in rectal cancer survivors. The factors that adversely affect these are abdominoperineal resection andshorter interval. The findings may encourage life-long follow-up and cooperation with patients, which shouldbe mentioned during the initial counseling.