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Long‐term anorectal function in rectal cancer patients treated with chemoradiotherapy and endorectal brachytherapy
Aim The aim was to study anorectal function in long‐term survivors after combined, curatively intended, chemoradiotherapy and endorectal brachytherapy for low rectal cancer. Methods This was a case–control design. We compared anorectal function by anal manometry, anal functional lumen imaging probe...
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| Published in: | Colorectal disease 2021-09, Vol.23 (9), p.2311-2319 |
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| container_title | Colorectal disease |
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| creator | Faaborg, Pia Møller Haas, Susanne Liao, Donghua Ploen, John Jakobsen, Anders Rahr, Hans Bjarke Laurberg, Soeren Gregersen, Hans Lundby, Lilli Christensen, Peter Krogh, Klaus |
| description | Aim
The aim was to study anorectal function in long‐term survivors after combined, curatively intended, chemoradiotherapy and endorectal brachytherapy for low rectal cancer.
Methods
This was a case–control design. We compared anorectal function by anal manometry, anal functional lumen imaging probe (EndoFLIP) and rectal bag distension in rectal cancer patients (RCPs) and healthy, normal subjects (NSs). Symptoms were assessed by the low anterior resection syndrome (LARS) and Wexner faecal incontinence scores.
Results
Thirteen RCPs (12 men, median age 68 years, range 52–92) after 60 Gy radiotherapy, 5 Gy endorectal brachytherapy and oral tegafur‐uracil with complete clinical response (median time since treatment 2.8 years, range 2.2–5.6) were compared to 15 NSs (14 men, median age 64 years, range 47–75). RCPs had lower than normal anal resting pressure, 38.6 mmHg (range 8.8–67.7) versus 58.8 mmHg (25.7–105.2) (P |
| doi_str_mv | 10.1111/codi.15692 |
| format | article |
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The aim was to study anorectal function in long‐term survivors after combined, curatively intended, chemoradiotherapy and endorectal brachytherapy for low rectal cancer.
Methods
This was a case–control design. We compared anorectal function by anal manometry, anal functional lumen imaging probe (EndoFLIP) and rectal bag distension in rectal cancer patients (RCPs) and healthy, normal subjects (NSs). Symptoms were assessed by the low anterior resection syndrome (LARS) and Wexner faecal incontinence scores.
Results
Thirteen RCPs (12 men, median age 68 years, range 52–92) after 60 Gy radiotherapy, 5 Gy endorectal brachytherapy and oral tegafur‐uracil with complete clinical response (median time since treatment 2.8 years, range 2.2–5.6) were compared to 15 NSs (14 men, median age 64 years, range 47–75). RCPs had lower than normal anal resting pressure, 38.6 mmHg (range 8.8–67.7) versus 58.8 mmHg (25.7–105.2) (P < 0.003), and squeeze pressure, 117 mmHg (55.2–203) versus 188 mmHg (103–248) (P < 0.01). Squeeze‐induced pressure increase recorded by EndoFLIP was also lower in RCPs (q > 7.56, P < 0.001) as was the anal canal resistance to increasing distension (q = 3.13, P < 0.05). No differences in median rectal volume at first sensation (72 [22–158] vs. 82 [36–190] ml, P = 0.4) or at urge to defaecate (107 [42–227] vs. 132 [59–334] ml, P = 0.2) were found. However, maximum tolerable rectal volume was lower in RCPs (145 [59–319] vs. 222 [106–447] ml, P < 0.02). The median (range) low anterior resection syndrome score was 27 (0–39) for RCPs and 7 (0–23) for NSs (P < 0.001), while the Wexner score was 0 (0–5) versus 0 (0–4) (P = 0.56).
Conclusion
Radiotherapy combined with endorectal brachytherapy for rectal cancer causes long‐term anorectal symptoms, impaired anal sphincter function and reduced rectal capacity.]]></description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.15692</identifier><identifier>PMID: 33900676</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Anorectal ; Brachytherapy ; Cancer ; Chemoradiotherapy ; Colorectal cancer ; Distension ; Fecal incontinence ; functional outcome ; Patients ; Pressure ; Radiation therapy ; rectal cancer ; Rectum ; Sphincter ; Tegafur ; Uracil ; watch and wait</subject><ispartof>Colorectal disease, 2021-09, Vol.23 (9), p.2311-2319</ispartof><rights>2021 The Association of Coloproctology of Great Britain and Ireland</rights><rights>This article is protected by copyright. All rights reserved.</rights><rights>Copyright © 2021 The Association of Coloproctology of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3932-ff1b501bd83f6520339119da59537ff5f2619b832cc2c7557b851f17841a25d53</citedby><cites>FETCH-LOGICAL-c3932-ff1b501bd83f6520339119da59537ff5f2619b832cc2c7557b851f17841a25d53</cites><orcidid>0000-0003-4571-4472</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33900676$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Faaborg, Pia Møller</creatorcontrib><creatorcontrib>Haas, Susanne</creatorcontrib><creatorcontrib>Liao, Donghua</creatorcontrib><creatorcontrib>Ploen, John</creatorcontrib><creatorcontrib>Jakobsen, Anders</creatorcontrib><creatorcontrib>Rahr, Hans Bjarke</creatorcontrib><creatorcontrib>Laurberg, Soeren</creatorcontrib><creatorcontrib>Gregersen, Hans</creatorcontrib><creatorcontrib>Lundby, Lilli</creatorcontrib><creatorcontrib>Christensen, Peter</creatorcontrib><creatorcontrib>Krogh, Klaus</creatorcontrib><title>Long‐term anorectal function in rectal cancer patients treated with chemoradiotherapy and endorectal brachytherapy</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description><![CDATA[Aim
The aim was to study anorectal function in long‐term survivors after combined, curatively intended, chemoradiotherapy and endorectal brachytherapy for low rectal cancer.
Methods
This was a case–control design. We compared anorectal function by anal manometry, anal functional lumen imaging probe (EndoFLIP) and rectal bag distension in rectal cancer patients (RCPs) and healthy, normal subjects (NSs). Symptoms were assessed by the low anterior resection syndrome (LARS) and Wexner faecal incontinence scores.
Results
Thirteen RCPs (12 men, median age 68 years, range 52–92) after 60 Gy radiotherapy, 5 Gy endorectal brachytherapy and oral tegafur‐uracil with complete clinical response (median time since treatment 2.8 years, range 2.2–5.6) were compared to 15 NSs (14 men, median age 64 years, range 47–75). RCPs had lower than normal anal resting pressure, 38.6 mmHg (range 8.8–67.7) versus 58.8 mmHg (25.7–105.2) (P < 0.003), and squeeze pressure, 117 mmHg (55.2–203) versus 188 mmHg (103–248) (P < 0.01). Squeeze‐induced pressure increase recorded by EndoFLIP was also lower in RCPs (q > 7.56, P < 0.001) as was the anal canal resistance to increasing distension (q = 3.13, P < 0.05). No differences in median rectal volume at first sensation (72 [22–158] vs. 82 [36–190] ml, P = 0.4) or at urge to defaecate (107 [42–227] vs. 132 [59–334] ml, P = 0.2) were found. However, maximum tolerable rectal volume was lower in RCPs (145 [59–319] vs. 222 [106–447] ml, P < 0.02). The median (range) low anterior resection syndrome score was 27 (0–39) for RCPs and 7 (0–23) for NSs (P < 0.001), while the Wexner score was 0 (0–5) versus 0 (0–4) (P = 0.56).
Conclusion
Radiotherapy combined with endorectal brachytherapy for rectal cancer causes long‐term anorectal symptoms, impaired anal sphincter function and reduced rectal capacity.]]></description><subject>Anorectal</subject><subject>Brachytherapy</subject><subject>Cancer</subject><subject>Chemoradiotherapy</subject><subject>Colorectal cancer</subject><subject>Distension</subject><subject>Fecal incontinence</subject><subject>functional outcome</subject><subject>Patients</subject><subject>Pressure</subject><subject>Radiation therapy</subject><subject>rectal cancer</subject><subject>Rectum</subject><subject>Sphincter</subject><subject>Tegafur</subject><subject>Uracil</subject><subject>watch and wait</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kctqGzEUhkVpaBy3mz5AEXQTApPqSNZclsG5GQzetOtBo0utMCM5kobgXR4hz5gniWI7WWQRbSSOPj4O_4_QTyDnkM8f6ZU9B1429AuawKxkBTCov-7etKgbIMfoJMY7QqCsoP6GjhlrCCmrcoLS0rv_z49PSYcBC-eDlkn02IxOJusdtg4fRlI4qQPeiGS1SxGnoEXSCj_YtMZyrQcfhLI-rXUQm212KaydehN2Qcj19vD5HR0Z0Uf943BP0b_rq7_z22K5ulnML5aFZA2jhTHQcQKdqpkpOSV5a4BGCd5wVhnDDS2h6WpGpaSy4rzqag4GqnoGgnLF2RSd7r2b4O9HHVM72Ch13wun_RhbyqGuchRNmdHfH9A7PwaXt8tUDo3O-I4621My-BiDNu0m2EGEbQukfe2ife2i3XWR4V8H5dgNWr2jb-FnAPbAg-319hNVO19dLvbSF_G5ldk</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Faaborg, Pia Møller</creator><creator>Haas, Susanne</creator><creator>Liao, Donghua</creator><creator>Ploen, John</creator><creator>Jakobsen, Anders</creator><creator>Rahr, Hans Bjarke</creator><creator>Laurberg, Soeren</creator><creator>Gregersen, Hans</creator><creator>Lundby, Lilli</creator><creator>Christensen, Peter</creator><creator>Krogh, Klaus</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4571-4472</orcidid></search><sort><creationdate>202109</creationdate><title>Long‐term anorectal function in rectal cancer patients treated with chemoradiotherapy and endorectal brachytherapy</title><author>Faaborg, Pia Møller ; Haas, Susanne ; Liao, Donghua ; Ploen, John ; Jakobsen, Anders ; Rahr, Hans Bjarke ; Laurberg, Soeren ; Gregersen, Hans ; Lundby, Lilli ; Christensen, Peter ; Krogh, Klaus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3932-ff1b501bd83f6520339119da59537ff5f2619b832cc2c7557b851f17841a25d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anorectal</topic><topic>Brachytherapy</topic><topic>Cancer</topic><topic>Chemoradiotherapy</topic><topic>Colorectal cancer</topic><topic>Distension</topic><topic>Fecal incontinence</topic><topic>functional outcome</topic><topic>Patients</topic><topic>Pressure</topic><topic>Radiation therapy</topic><topic>rectal cancer</topic><topic>Rectum</topic><topic>Sphincter</topic><topic>Tegafur</topic><topic>Uracil</topic><topic>watch and wait</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Faaborg, Pia Møller</creatorcontrib><creatorcontrib>Haas, Susanne</creatorcontrib><creatorcontrib>Liao, Donghua</creatorcontrib><creatorcontrib>Ploen, John</creatorcontrib><creatorcontrib>Jakobsen, Anders</creatorcontrib><creatorcontrib>Rahr, Hans Bjarke</creatorcontrib><creatorcontrib>Laurberg, Soeren</creatorcontrib><creatorcontrib>Gregersen, Hans</creatorcontrib><creatorcontrib>Lundby, Lilli</creatorcontrib><creatorcontrib>Christensen, Peter</creatorcontrib><creatorcontrib>Krogh, Klaus</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Faaborg, Pia Møller</au><au>Haas, Susanne</au><au>Liao, Donghua</au><au>Ploen, John</au><au>Jakobsen, Anders</au><au>Rahr, Hans Bjarke</au><au>Laurberg, Soeren</au><au>Gregersen, Hans</au><au>Lundby, Lilli</au><au>Christensen, Peter</au><au>Krogh, Klaus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long‐term anorectal function in rectal cancer patients treated with chemoradiotherapy and endorectal brachytherapy</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2021-09</date><risdate>2021</risdate><volume>23</volume><issue>9</issue><spage>2311</spage><epage>2319</epage><pages>2311-2319</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract><![CDATA[Aim
The aim was to study anorectal function in long‐term survivors after combined, curatively intended, chemoradiotherapy and endorectal brachytherapy for low rectal cancer.
Methods
This was a case–control design. We compared anorectal function by anal manometry, anal functional lumen imaging probe (EndoFLIP) and rectal bag distension in rectal cancer patients (RCPs) and healthy, normal subjects (NSs). Symptoms were assessed by the low anterior resection syndrome (LARS) and Wexner faecal incontinence scores.
Results
Thirteen RCPs (12 men, median age 68 years, range 52–92) after 60 Gy radiotherapy, 5 Gy endorectal brachytherapy and oral tegafur‐uracil with complete clinical response (median time since treatment 2.8 years, range 2.2–5.6) were compared to 15 NSs (14 men, median age 64 years, range 47–75). RCPs had lower than normal anal resting pressure, 38.6 mmHg (range 8.8–67.7) versus 58.8 mmHg (25.7–105.2) (P < 0.003), and squeeze pressure, 117 mmHg (55.2–203) versus 188 mmHg (103–248) (P < 0.01). Squeeze‐induced pressure increase recorded by EndoFLIP was also lower in RCPs (q > 7.56, P < 0.001) as was the anal canal resistance to increasing distension (q = 3.13, P < 0.05). No differences in median rectal volume at first sensation (72 [22–158] vs. 82 [36–190] ml, P = 0.4) or at urge to defaecate (107 [42–227] vs. 132 [59–334] ml, P = 0.2) were found. However, maximum tolerable rectal volume was lower in RCPs (145 [59–319] vs. 222 [106–447] ml, P < 0.02). The median (range) low anterior resection syndrome score was 27 (0–39) for RCPs and 7 (0–23) for NSs (P < 0.001), while the Wexner score was 0 (0–5) versus 0 (0–4) (P = 0.56).
Conclusion
Radiotherapy combined with endorectal brachytherapy for rectal cancer causes long‐term anorectal symptoms, impaired anal sphincter function and reduced rectal capacity.]]></abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33900676</pmid><doi>10.1111/codi.15692</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4571-4472</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Anorectal Brachytherapy Cancer Chemoradiotherapy Colorectal cancer Distension Fecal incontinence functional outcome Patients Pressure Radiation therapy rectal cancer Rectum Sphincter Tegafur Uracil watch and wait |
| title | Long‐term anorectal function in rectal cancer patients treated with chemoradiotherapy and endorectal brachytherapy |
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