Quality of Life Analysis in Anal Squamous Cell Carcinoma Cases Treated with IMRT: A Single-Center Cross-Sectional Study

OBJECTIVE
The standard treatment for anal cancer involves chemoradiotherapy (CRT), often resulting in long-term side effects that impact patients’ quality of life (QoL). The present study aimed to analyse the long-term QoL in anal squamous cell carcinoma (SCC) cases treated with intensity-modulated radiation therapy (IMRT).
METHODS
Between January 2007 and January 2022, 27 anal SCC cases were treated with definitive radiotherapy (RT) or CRT with IMRT. The EORTC QLQ-C30 and EORTC QLQ-CR29 scales were used for data collection.
RESULTS
The mean score for Global Health status/QoL was 72±22.9 and functional scales (range, 84.5-93.8) were generally high, indicating a favourable QoL in the EORTC QLQ-C30 scale. The highest symptom scores were observed for fatigue, insomnia, and financial difficulty. Notably, age (<65 vs. ≥65) was identified as a factor influencing Global Health status/QoL, with patients <65 years of age experiencing a more positive impact. In EORTC QLQ-CR29, although functional scales showed favourable outcomes in body image, anxiety and weight, sexual interest for males (24.8±34.4) and females (10.4±15.7) was impaired, while symptoms like impotence (37.2±32.9) and dyspareunia (31.3±34) scored high. The third-highest symptom was urinary frequency (20.7±27.1). Age ≥65 years was associated with increased symptoms of buttock pain, flatulence and anxiety.
CONCLUSION
Among anal SCC survivors treated with IMRT, functional scores were generally high, whereas clinically relevant sexual function problems were observed. Given the limited sample size and the multiple QoL domains examined, these exploratory findings should be considered hypothesis-generating rather than confirmatory.

Keywords: Anus neoplasms; intensity-modulated radiotherapy; quality of life