A study of patient-reported outcomes (PROs) in patients undergoing chemoradiation therapy for anal cancer suggests that patients initially experience a worsening of gastrointestinal (GI) symptoms with treatment, but that this worsening typically subsides within a few months of starting treatment. These findings were reported in JCO Oncology Practice.1

Patients included in this prospective analysis had nonmetastatic anal squamous cell carcinoma. All patients received definitive chemoradiotherapy (21 patients), and they were given a survey that consisted of the bowel subdomain of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. EPIC scores for this subdomain were compared for subjects across timepoints at baseline and at 1 week, 3 weeks, 5 weeks, and 3 months after the start of therapy.

Slightly more than half of patients (52%) showed T2 tumor disease, and 81% of patients had N0 or N1 classification. The most common chemoradiotherapy approach was cisplatin plus fluorouracil with radiation given as intensity-modulated radiotherapy or volumetric modulated arc therapy.

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The overall baseline median EPIC score for this population was 66, and at 1 week the median score had shifted to 82 (P =.009), signaling a worsening of symptoms. However, at 5 weeks, the median score had dropped to 54 (P =.025). Overall, from baseline to 3 months, there was not a significant difference in median score (P =.919).

The researchers concluded that there was a fluctuation in PROs related to GI symptoms for these patients with anal cancer receiving chemoradiotherapy, but by 3 months PROs appeared to stabilize to baseline levels. The researchers concluded that “this highlights the importance of incorporating PRO tools into the treatment of patients with anal cancer to assess and address treatment-related adverse effects as soon as they arise.”


Kouzy R, Jauoude JA, Lin D, et al. Patient-reported GI outcomes in patients with anal cancer receiving modern chemoradiation [published online July 1, 2020]. JCO Oncol Pract. doi: 10.1200/OP.20.00122