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首页> 外文期刊>International journal of colorectal disease. >Comparative analysis of late functional outcome following preoperative radiation therapy or chemoradiotherapy and surgery or surgery alone in rectal cancer
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Comparative analysis of late functional outcome following preoperative radiation therapy or chemoradiotherapy and surgery or surgery alone in rectal cancer

机译：直肠癌术前放疗或放化疗后以及单独手术或手术后晚期功能结局的比较分析

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Purpose: This study evaluates the anorectal and genitourinary function of patients treated by preoperative short-term radiotherapy (RT) or chemoradiotherapy (CRT) followed by surgery and surgery alone for rectal cancer. Methods: For this study, a total of 613 patients, who were identified from a prospective rectal cancer database, underwent anterior resection of the rectum between October 2001 and December 2007. Standardized questionnaires were used to determine fecal incontinence, urinary, and sexual function. Relevant clinical variables were evaluated using univariate and multivariate analyses. Independent predictors of functional outcome were identified by a binary logistic regression analysis. Results: The data of 263 (43 %) patients were available for analysis. On multivariate analysis, neoadjuvant RT (P < 0.01) and low anterior resection (LAR) (P = 0.049) were associated with fecal incontinence. In univariate analysis, fecal incontinence was linked to preoperative neoadjuvant treatment (RT and/or CRT vs. LAR) (P < 0.01). The hazard ratio for developing fecal incontinence was 3.3 (1.6-6.8) for patients who received RT. One hundred twenty-five patients (51.2 %) experienced urinary incontinence following surgery, the majority of whom were female (P < 0.01). On univariate analysis, male sexual function was associated with age (P < 0.01), ASA class (P = 0.01) and LAR (P = 0.01). Conclusion: Multimodal therapy of low rectal cancer increases the incidence of fecal incontinence and negatively affects sexual function. The potential benefits of RT or CRT need to be balanced against the risk of increased bowel dysfunction when determining the appropriate treatment for individual patients with rectal cancer.
机译：目的：本研究评估了术前短期放疗（RT）或放化疗（CRT），然后进行手术和单独治疗直肠癌的患者的肛门直肠和泌尿生殖功能。方法：在本研究中，从前瞻性直肠癌数据库中识别出的613例患者在2001年10月至2007年12月之间接受了直肠前切除术。使用标准化问卷调查了大便失禁，尿液和性功能。使用单变量和多变量分析评估相关的临床变量。通过二进制逻辑回归分析确定功能结果的独立预测因子。结果：263例患者的数据（43％）可供分析。在多变量分析中，新辅助放疗（P <0.01）和低位前切除（LAR）（P = 0.049）与大便失禁相关。在单因素分析中，粪便失禁与术前新辅助治疗（RT和/或CRT vs. LAR）相关（P <0.01）。接受放疗的患者发生大便失禁的危险比为3.3（1.6-6.8）。一百二十五名患者（51.2％）在手术后出现尿失禁，其中大多数为女性（P <0.01）。单因素分析显示，男性性功能与年龄（P <0.01），ASA类别（P = 0.01）和LAR（P = 0.01）相关。结论：低位直肠癌的多模式治疗增加了大便失禁的发生率，并对性功能产生负面影响。在确定针对个体直肠癌患者的适当治疗方法时，需要权衡放疗或CRT的潜在益处与肠功能障碍增加的风险。

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