Assessment of patient-reported measures of bowel function before and after pelvic radiotherapy: an ancillary study of the North Central Cancer Treatment Group study N00CA

Abstract

Purpose The Bowel Function Questionnaire (BFQ) has been used in clinical trials to assess symptoms during and after pelvic radiotherapy (RT). This study evaluated the importance of symptoms in the BFQ from a patient perspective. Methods Patients reported presence or absence of symptoms and rated importance of symptoms at baseline, 4 weeks after completion of pelvic RT, and 12 and 24 months after RT. The BFQ measured overall quality of life (QOL) and symptoms of nocturnal bowel movements, incontinence, clustering, need for protective clothing, inability to differentiate stool from gas, liquid bowel movements, urgency, cramping, and bleeding. Bowel movement frequency also was recorded. A content validity questionnaire was used to rate symptoms as “not very important,” “moderately unimportant,” “neutral,” “moderately important,” or “very important.” Results Most of the 125 participating patients rated all symptoms as moderately or very important. Generally, patients gave similar ratings for symptom importance at all study points, and ratings were independent of whether the patient experienced the symptom. Measures of greatest importance (moderately or very important) at baseline were ability to control bowel movements (94%), not having to wear protective clothing (90%), and not having rectal bleeding (94%). With the exception of need for protective clothing, the presence of a symptom at 4 weeks was associated with significantly worse QOL (P<.01 for all). Conclusions The BFQ has excellent content validity. Patients rated most symptoms as moderately or very important, indicating the BFQ is an appropriate tool for symptom assessment during and after pelvic RT.

Long‐term bowel function patient‐reported outcomes after successful chemoradiation for carcinoma of the anal canal

“…Interestingly, prior studies have noted that pelvic radiation has a detrimental effect on bowel function [13]. We did not find the same effect in the anal cancer population treated with similar radiation.…”

Gut Microbial Dysbiosis May Predict Diarrhea and Fatigue in Patients Undergoing Pelvic Cancer Radiotherapy: A Pilot Study

“…However, gastrointestinal symptoms induced by pelvic radiotherapy remain a long-standing and unresolved problem. Especially, fatigue and diarrhea, which are frequently experienced by pelvic radiotherapy patients, have harmful impact on the quality of patients’ life and not infrequently lead to the suspension of treatment [ 29 ]. In this pilot study, we assessed the symptoms of fatigue and diarrhea, inflammatory markers, and fecal microbial ecology of 11 cancer patients over their five-week pelvic radiotherapy course.…”

What Are the Best Questionnaires To Capture Anorectal Function After Surgery in Rectal Cancer?

“…On the other hand, there are some anorectal function questionnaires that have been more rigorously tested, yet are not entirely suitable to be administered after surgery in rectal cancer; for instance, the American Medical Systems fecal incontinence scoring system [ 39 ], which was formulated for assessing the function of artificial anal sphincters, and the Bowel Function Questionnaire (BFQ) [ 40 , 41 ], which focuses on symptoms during and after pelvic radiotherapy, as well as those caused by pharmacologic agents, instead of surgery [ 40 – 44 ].…”