S717
Clinical – Lower GI
ESTRO 2026
Marianne Grønlie Guren 10,11 , Mark Harrison 3 , Therese Juul 5 , Rahul Krishnatry 4 , Anjali Kumari 4 , Vicky McFarlane 6 , Michele Powell 12 , Omar Shamieh 2,13 , Karen-Lise Garm Spindler 5 , Kostas Svoliantopoulos 14 , Maria Tolia 15 , George Tsironis 16 , Vasilis Vasiliou 17 1 School of Health Sciences, University of Southampton, Southampton, United Kingdom. 2 Centre for Palliative & Cancer Care in Conflict, King Hussein Cancer Centre, Amman, Jordan. 3 Mount Vernon Cancer Centre, East and North Hertfordshire Teaching NHS Trust, Northwood, United Kingdom. 4 Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India. 5 Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. 6 Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom. 7 Department of Research, Bank of Cyprus Oncology Center, Nicosia, Cyprus. 8 Leeds Institute of Medical Research at St James’s, St James’s University Hospital, Leeds, United Kingdom. 9 Sussex Cancer Research Centre, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom. 10 Department of Oncology, Oslo University Hospital, Oslo, Norway. 11 Medicine, The University of Oslo, Oslo, Norway. 12 Clinical Research Facility, University Hospitals NHS Foundation Trust, Brighton, United Kingdom. 13 Department of Palliative Medicine, King Hussein Cancer Center, Amman, Jordan. 14 Department of Medical Oncology, University Hospital of Heraklion, Crete, Greece. 15 Department of Radiation Oncology, University Hospital of Heraklion, Crete, Greece. 16 Medical Oncology, Bank of Cyprus Oncology Center, Nicosia, Cyprus. 17 Department of Radiation Oncology, Bank of Cyprus Oncology Center, Nicosia, Greece Purpose/Objective: Anal carcinomas are rare, but worldwide incidence is increasing. Radical chemoradiotherapy, achieves 5- year survival rates of 75%, but is associated with acute and chronic toxicity/complications that impair the health-related quality of life of patients during and post treatment(1).The European Organisation for Research and Treatment in Cancer (EORTC) health- related quality of life questionnaire for anal cancer (QLQ-ANL27) was developed as a measure of quality of life (QoL) specifically for patients with anal cancer treated with radical chemoradiotherapy(2).For 15-20% of patients with Anal Cancer their disease will metastasise, recur, or persist beyond treatment (3,4). It is unclear whether the current questionnaire is appropriate for those patients.The aim of this study is to identify the QoL issues of such patients and determine to what extent the current questionnaire remains suitable, or requires modification, for this patient group. Material/Methods: A systematic literature review and interviews with
patients and professionals were conducted to capture participants views on the current questionnaires and identify the QoL issues experienced by this patient group. QoL issues raised were compared against those of the QLQ-ANL27 along with the core cancer generic questionnaire the QLQ-C30, then scrutinised further by a panel of experts to group, differentiate, and identify novel issues. Results: Patients (n=19) and Professionals (n=10) were recruited across five countries (Cyprus, Greece, India, Jordan, UK). The majority of participants did not feel anything should be excluded from the current questionnaire. However, 33 new issues were identified that are not present in the current questionnaire. Commonly reported new issues included; psychological issues such as embarrassment, concerns around body image, and feeling less sexually attractive; physiological issues such as sensations relating to neuropathy, pain in newly identified locations, and additional forms of urinary disfunction. Conclusion: The current questionnaire captures many QoL issues experienced by people with metastatic and/or recurrent / persistent anal cancer. However, findings suggest this patient group may experience several additional issues, due to new treatments and the enduring nature of incurable disease. Further work is now needed to sort the novel issues identified into a manageable number of specific items that can be asked as part of a comprehensive, but tolerable, measure to capture the experience of people living with incurable anal cancer. References: 1) Sekhar H, et al. (2020) Temporal improvements in loco-regional failure and survival in patients with anal cancer treated with chemo-radiotherapy: treatment cohort study (1990-2014). Br J Cancer. ;122(6):749- 758.2) Sodergren SC, et al. (2023) International validation of the EORTC QLQ-ANL27, a field study to test the anal cancer-specific health-related quality-of- life questionnaire. Int J Radiat Oncol Biol Phys 115(5):1155–1164.3) Deshmukh AA, et al.(2020) Recent trends in squamous cell carcinoma of the anus incidence and mortality in the United States, 2001– 2015. J Natl Cancer Inst 112(8):829–838.4) Slørdahl KS, et al.(2021) Treatment outcomes and prognostic factors after chemoradiotherapy for anal cancer. Acta Oncol 60(7):921–930. Keywords: Anal cancer, Chemoradiotherapy, Quality of Life
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