Impaired health-related quality of life after chemoradiotherapy for anal cancer: Late effects in a national cohort of 128 survivors

Figures & data

Figure 1. Inclusion of anal cancer survivors.

Table I. Patient-, tumour- and treatment characteristics of the responding and the non-responding survivors.

	Survivors responding, n = 128	Survivors non-responding, n = 71	p-value^3
Sex			0.492
Women	101 (79%)	53 (75%)
Men	27 (21%)	18 (25%)
Age, median, years (range)	61 (40–89)	71 (39–92)	< 0.001
T-stage^1			0.486
T1	25 (20%)	8 (11%)
T2	53 (41%)	32 (45%)
T3	27 (21%)	16 (23%)
T4	22 (17%)	15 (21%)
TX	1 (1%)
N-stage^2			0.485
N0	87 (68%)	52 (73%)
N1-3	40 (31%)	19 (27%)
NX	1 (1%)
Radiotherapy, median total dose, Gy (range)	54 (44–64)	54 (38–66)	0.145
Chemotherapy	119 (93%)	62 (87%)	0.125
Stoma	21 (16%)	14 (20%)	0.557
Medical comorbidity	36 (28%)	40 (56%)	< 0.001

¹T-stage, tumour stage (according to TNM-classification);

²N-stage, lymph node stage (according to TNM-classification);

^3χ2-tests for categorical variables and Student's t-tests for continuous variables.

Table II. EORTC QLQ-C30 mean scores of anal cancer survivors compared to volunteers.

	Survivors n = 128		Volunteers n = 269		Numerical difference^1	p-value^2
	Mean score	SD	Mean score	SD
Functional scales
Physical functioning	77	22	90	15	+ 13	< 0.001
Role functioning	69	31	91	19	+ 22	< 0.001
Emotional functioning	77	25	87	16	+ 10	< 0.001
Cognitive functioning	77	26	89	15	+ 12	< 0.001
Social functioning	71	29	91	18	+ 20	< 0.001
Symptom scales and items
Fatigue	38	28	20	18	+ 18	< 0.001
Nausea and vomiting	6	13	3	10	+ 3	0.053
Pain	25	30	14	23	+ 11	0.003
Dyspnoea	27	33	10	20	+ 17	< 0.001
Insomnia	35	35	20	26	+ 15	< 0.001
Appetite loss	14	24	3	12	+ 11	< 0.001
Constipation	22	28	14	22	+ 8	0.016
Diarrhoea	27	32	12	21	+ 15	< 0.001
Financial problems	14	27	4	14	+ 10	< 0.001
Global health status	68	25	83	19	+ 15	< 0.001

¹On the 0-100 scale, a variation in score > 10 points indicates a moderate clinical difference and a variation in score > 20 points a large clinical difference; ²Conditional logistic regression. SD, standard deviation.

Figure 2. EORTC QLQ-C30 mean scores. Data from age- and sex-matched volunteers, compared to Norwegian and Dutch normative data corrected according to age- and sex- distribution among volunteers.

Table III. EORTC QLQ-CR29 mean scores of anal cancer survivors compared to volunteers.

	Survivors n = 128		Volunteers n = 269		Numerical difference^1	p-value^2
	Mean Score	SD	Mean Score	SD
CR29 scales
Urinary frequency	29	28	15	21	+ 14	< 0.001
Blood/mucus in stool	13	17	3	8	+ 10	< 0.001
Stool frequency	19	21	4	9	+ 15	< 0.001
Body image	72	31	79	24	+ 7	0.057
CR29 single items
Urinary incontinence	17	26	8	15	+ 9	0.001
Dysuria	8	19	1	7	+ 7	< 0.001
Abdominal pain	14	22	9	18	+ 5	0.074
Buttock pain	25	32	4	14	+ 21	< 0.001
Bloating	31	29	22	25	+ 9	0.007
Anxiety	62	33	80	22	+ 18	< 0.001
Weight	76	31	82	24	+ 6	0.099
Flatulence	47	32	18	23	+ 29	< 0.001
Faecal incontinence	29	31	3	10	+ 26	< 0.001
Sexual interest (men)	44	32	58	23	+ 14	0.082
Impotence (men)	69	37	25	35	+ 44	< 0.001
Sexual interest (women)	23	27	39	28	+ 16	< 0.001
Dyspareunia (women)	28	34	11	22	+ 17	< 0.001

¹On the 0-100 scale, a variation in score > 10 points indicates a moderate clinical difference and a variation in score > 20 points a large clinical difference; ²Conditional logistic regression. SD, standard deviation.

Figure 3. Frequency of moderate to severe symptoms from EORTC QLQ-C30, EORTC QLQ-CR29 and telephone interview in anal cancer survivors compared with age- and sex-matched volunteers. *p < 0.05 conditional logistic regression.

Figure 4. SCIN scores for anal cancer survivors treated with cisplatin (Cis+, n=56) and without cisplatin (Cis−, n=72). *p=0.004 chi-square test.