Introduction: Treatments for colorectal and anal cancers can have a detrimental impact on sexual function. Type of treatment, which may include surgery, radiation and/or chemotherapy, varies by disease site and severity. Treatment and long-term side effects can impact sexual function and intimacy for patients and their partners. Aim: To review the literature regarding treatment for colorectal/anal cancer and its impact on female sexual function, and to provide an assessment of medical outcomes and patient-reported outcomes (PROs) of women with a history of colon, rectal, or anal cancer seeking sexual health treatment. Methods: We performed a PubMed search to identify peer-reviewed, English-language articles, published from 2008 to 2018, using the following search terms: "colorectal cancer," or "rectal cancer," or "anal cancer" and "sexual function," or "sexual dysfunction." We also assessed the medical outcomes and PROs from our recent cross-sectional cohort study of 99 women with a history of colon, rectal, or anal cancer seeking sexual health treatment. Main Outcome Measures: Sexual function, quality of life, and PROs after colorectal/anal cancer Results: Twenty-three studies were identified. Study designs included 15 cross-sectional survey studies, 5 longitudinal studies, 2 psychoeducational interventions, and 1 pilot study. Ten studies included women and 13 included both men and women. The literature and our cohort confirmed
To report prospectively collected physician-reported adverse events (AEs) and patient reported outcomes (PRO) for patients treated with adjuvant radiation therapy (RT) for uterine cancer. Materials/Methods: Patients with uterine malignancies treated with curative-intent RT at our institution between 2014 and 2018 were identified. For inclusion in this analysis, histologic confirmation of uterine malignancy, receipt of adjuvant external beam RT, and completion of baseline and post-treatment questionnaires were required. Physician-reported AEs were prospectively assessed prior to, immediately upon completion of RT, and 3 months post-RT using CTCAE Version 4.0. Patients were enrolled on a prospective PRO registry to assess quality of life using a gynecologic specific subset of the PRO-CTCAE designed to assess symptom impact on daily living. Results: 77 patients met inclusion criteria. 71% of patients received chemotherapy prior to RT, 5.8% of patients received concurrent chemotherapy and 39.5% of patients received chemotherapy following RT. Median RT dose delivered was 4760 cGy (range 4500-6600 cGy). 73% patients underwent vaginal cuff brachytherapy (1000-2000 cGy in 2-4 fractions). There were no grade 3, 4, or 5 AEs. There were 96 grade 1 and 2 AEs: gastrointestinal (67.5%), urinary (19.5%), constitutional (24.7%), gynecologic (9%) and dermatologic (5.2%). At 3 months, 9 grade 1 and 2 toxicities were reported: gynecologic (1.3%), lymph (3.9%), gastrointestinal (2.6%), constitutional (2.6%) and urinary (1.3%). PRO-CTCAE was completed by 36 patients. PRO data were collected on a 5 point scale with score of 3-5 considered high toxicity: occasionally, frequently or almost constantly; somewhat, quite a bit or very much; moderate, severe or very severe. Proportions of patients with high toxicity scores are reported in the table below. Results showed minimal compromise in quality of life at end of treatment and 3 month post-RT in comparison to baseline function. Most symptoms reported at the end of treatment resolved within 3 months. Conclusion: Adjuvant radiation therapy is well tolerated in patients with uterine cancer with minimal acute toxicity and resolution of most patient reported symptoms at 3 months.
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