Management of late adverse effects after chemoradiation for anal cancer

Authors

  • Susanne Haas Danish Cancer Society, National Research Centre for Survivorship and Late Adverse Effects following Pelvic Organ Cancer, Department of Surgery, Aarhus University Hospital, Aalborg, Denmark
  • Anette H. Mikkelsen Sexological Center, Aalborg University Hospital, Aalborg, Denmark
  • Camilla Kronborg Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
  • Birthe T. Oggesen Department of Surgery, Herlev Hospital, Herlev, Denmark
  • Pia Moeller Faaborg Department of Surgery, Vejle Hospital, Danish Colorectal Cancer Centre South, Vejle, Denmark
  • Eva Serup-Hansen Department of Oncology, Herlev Hospital, Herlev, Denmark
  • Karen-Lise G. Spindler Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
  • Peter Christensen Danish Cancer Society, National Research Centre for Survivorship and Late Adverse Effects following Pelvic Organ Cancer, Department of Surgery, Aarhus University Hospital, Aalborg, Denmark

DOI:

https://doi.org/10.1080/0284186X.2021.1983208

Keywords:

Anal cancer, anal cancinoma, late adverse effects, late toxicity, guideline

Abstract

Background and purpose

Significant improvements in the treatment of anal cancer have produced a growing population of anal cancer survivors. These patients often experience late adverse effects related to their treatment. Research has revealed substantial unmet needs because of long-term symptoms and functional impairments after treatment that may negatively affect health-related quality of life. The purpose of the present guidelines is to review the scientific evidence for the management of late adverse effects after (chemo)radiotherapy ([C]RT) for anal cancer and to extrapolate knowledge from other pelvic malignancies treated with pelvic (C)RT so that they may guide the clinical management of late adverse effects.

Materials and methods

Relevant studies were systematically searched in four databases from their inception to June 2020 (no language limitation) and guidelines were searched in 16 databases, focussing on bowel dysfunction, psychosocial aspects, pain, and sexual and urinary dysfunction. The guidelines were developed by a panel of experts using the Oxford Centre for Evidence-based Medicine, levels of evidence, and grades of recommendations.

Scientific evidence

Late adverse effects after (C)RT for anal cancer are associated with a low overall quality of life among survivors. The most pronounced late adverse effects are bowel dysfunction (present in up to 78%), urinary dysfunction (present in up to 45%), and sexual dysfunction (present in up to 90% of men and up to 100% of women). Only indirect data on adequate treatment options of these late adverse effects for anal cancer are available.

Conclusion

Quality of life and late adverse effects should be monitored systematically following treatment for anal cancer to identify patients who require further specialist evaluation or support. Increased awareness of the extent of the problem may serve to stimulate and facilitate multidisciplinary collaboration, which is often required.

Downloads

Download data is not yet available.

Downloads

Published

2021-11-30

How to Cite

Haas, S., Mikkelsen, A. H., Kronborg, C., Oggesen, B. T., Moeller Faaborg, P., Serup-Hansen, E., … Christensen, P. (2021). Management of late adverse effects after chemoradiation for anal cancer. Acta Oncologica, 60(12), 1688–1701. https://doi.org/10.1080/0284186X.2021.1983208

Issue

Vol. 60 No. 12 (2021): Acta Oncologica

Section

Articles