In a single-institution study reported in JCO Oncology Practice, Kouzy et al found that gastrointestinal (GI)-related patient-reported outcomes among those receiving chemoradiation for anal cancer improved vs baseline at 1 week after treatment initiation, were worse vs baseline at 5 weeks, but did not differ from baseline at 3 months.

Study Details

The study included 21 patients receiving definitive chemoradiotherapy for nonmetastatic squamous cell carcinoma of the anal canal at The University of Texas MD Anderson Cancer Center. Patients had a median age of 57; most had T2 (52%) and either N0 or N1 disease (81%); and most received chemotherapy with cisplatin/fluorouracil (91%) and either intensity-modulated radiotherapy or volumetric modulated arc therapy (91%). Patients completed the bowel subdomain of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire before treatment and at 1, 3, and 5 weeks and 3 months after the start of treatment. The EPIC overall, bother, and function summary scores range from 0 to 100, with higher scores indicating better outcome.

Key Findings

At baseline, patients had a median overall summary score of 66, a median bother summary score of 64, and a median function summary score of 64.  

At 1 week after initiation of treatment, the median overall summary score was 82 (P = .009 vs baseline), the median bother summary score was 89 (P = .002 vs baseline), and the median function summary score was 79 (P = .244 vs baseline).

At 3 weeks, median overall, bother, and function summary scores were 61 (P =.108), 64 (P = .139), and 64 (P = .063), respectively, with none differing significantly vs baseline.

At 5 weeks, the median overall, bother, and function summary scores were 54 (P = .025), 54 (P =.019), and 54 (P =.030)—all significantly lower vs baseline.

At 3 months, the median overall, bother, and function summary scores were 68 (P = .919), 65 (P = .944), and 71 (P = .878), with none differing significantly vs baseline.

The differences from baseline in overall summary score at 1 week (better than baseline) and 5 weeks (worse than baseline), bother summary score at 1 week (better) and 5 weeks (worse), and function summary score at 5 weeks (worse) were considered clinically significant.

The investigators concluded, “The GI-related patient-reported outcomes of patients with anal cancer tend to fluctuate during radiotherapy but return to baseline by 3 months, at which time most patients report few or no residual adverse effects. We provide a clear timeline of GI acute toxicity using sequential patient-reported outcome measurements that will improve patient-physician communication regarding expectations for cancer treatment.”

Cullen M. Taniguchi, MD, PhD, of the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, is the corresponding author for the JCO Oncology Practice article.

Disclosure: The study was supported by the National Institutes of Health, Cancer Prevention & Research Institute of Texas, and others. For full disclosures of the study authors, visit ascopubs.org.