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Patient Assessment of Bowel Function During and After Pelvic Radiotherapy: Results of a Prospective Phase III North Central Cancer Treatment Group Clinical Trial

Michael G. Haddock, Jeff A. Sloan, John W. Bollinger, Gamini Soori, Preston D. Steen, James A. Martenson

From the Mayo Clinic, Rochester, MN; Grand Forks, Ltd, Urbana, IL; the Missouri Valley Cancer Consortium, Omaha, NE; and the Merit Care Hospital Community Clinical Oncology Program, Fargo, ND

Address reprint requests to Michael G. Haddock, MD, Department of Radiation Oncology, Mayo Clinic, 200 First St SW, Rochester, MN 55905; e-mail: haddock.michael{at}mayo.edu

Purpose: To evaluate patient assessment of long-term effect of pelvic radiotherapy on bowel function.

Patients and Methods: As part of a prospective randomized trial evaluating the impact of sucralfate on bowel function in patients receiving pelvic radiotherapy, patient-assessed bowel function data were collected during radiotherapy and again at 4 weeks and 1 year after completion of radiotherapy.

Results: The number of bowel movements per day increased up to week 4 and then slowly decreased. At 1 year, the mean number of bowel movements per day had increased from 1.75 to 2.09 and the median from 1 to 2. All measures of adverse bowel function worsened during radiotherapy. Frequency of bowel movements and symptoms of frequency, nocturnal bowel movements, cramping, and bleeding returned close to baseline values by 1 year. Symptoms of urgency, clustering, and measures of incontinence were all persistent at 1 year. The mean increase in bowel function score at 1 year was 0.74 (range, –5 to 7).

Conclusion: Pelvic radiotherapy is associated with a slight increase in bowel movement frequency and decrease in several patient-reported measures of adverse bowel function. Several measures of adverse function persisted at 1 year.

This study was conducted as a collaborative trial of the North Central Cancer Treatment Group and Mayo Clinic and was supported in part by Public Health Service Grants No. CA-25224, CA-37404, CA-35269, CA-35103, CA-35195, CA-63849, CA-37417, CA-63848, CA-35448, CA-35415, CA-35101, CA-35113, CA-52352, and CA-35272 from the National Cancer Institute, US Department of Health and Human Services.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.