Background/Objectives:With recent advancements in rectal cancer management leading to longer patient survival, the impact of various treatment approaches on patients’ quality of life (QOL) becomes an important focus of attention. While QOL studies exist for watch-and-wait after (chemo)radiation with/without local excision, data on health-related QOL (HRQOL) outcomes after contact X-ray brachytherapy (CXB) remain limited. This study evaluated functional and HRQOL outcomes in rectal cancer patients undergoing CXB and (chemo)radiation over one year.Methods:This prospective observational study (enrolment January–October 2023) with one-year follow-up assessed functional and HRQOL outcomes after CXB and (chemo)radiation using EORTC-QLQ-CR29, HADS, and EQ-5D-3L questionnaires. Longitudinal analyses were conducted using linear mixed-effects models, incorporating both fixed and random effects, following data processing based on relevant scoring manuals.Results:QOL was assessed in 53 patients who attended our centre for CXB for various clinical indications, with 51, 47, and 42 remaining at the end of treatment, 6-month, and 12-month follow-ups, respectively. Overall, symptom and functional scores from EORTC-QLQ-CR29 remained stable throughout the follow-up period. Significant improvements were observed in abdominal pain, flatulence, urinary frequency, and body weight at 12 months. HADS and EQ-5D-3L scores remained stable, while EQ-VAS scores showed improvement, indicating a good overall quality of life following CXB treatment.Conclusions:CXB treatment combined with (chemo)radiation maintained stable HRQOL, with some improvements in symptoms and QOL noted during the subsequent year. These findings will help rectal cancer patients understand the benefits and limitations of CXB as a treatment option.
背景/目的：随着直肠癌治疗的最新进展使患者生存期延长，不同治疗方案对患者生活质量的影响成为重要关注点。目前已有关于（放）化疗后联合或不联合局部切除的"观察等待"策略对生活质量影响的研究，但关于接触式X线近距离放射治疗后健康相关生活质量结局的数据仍有限。本研究评估了接受接触式X线近距离放射治疗联合（放）化疗的直肠癌患者为期一年的功能状态与健康相关生活质量结局。 方法：这项前瞻性观察研究（2023年1月至10月入组）通过为期一年的随访，采用EORTC-QLQ-CR29量表、医院焦虑抑郁量表和欧洲五维健康量表评估接触式X线近距离放射治疗联合（放）化疗后的功能与健康相关生活质量结局。根据相关评分手册进行数据处理后，采用包含固定效应和随机效应的线性混合效应模型进行纵向分析。 结果：53名因不同临床指征在我中心接受接触式X线近距离放射治疗的患者完成了生活质量评估，其中治疗结束时、6个月和12个月随访时分别保留51例、47例和42例。总体而言，EORTC-QLQ-CR29量表的症状和功能评分在整个随访期间保持稳定。12个月时观察到腹痛、腹胀、尿频和体重方面均有显著改善。医院焦虑抑郁量表和欧洲五维健康量表评分保持稳定，而欧洲视觉模拟评分显示改善，表明接触式X线近距离放射治疗后整体生活质量良好。 结论：接触式X线近距离放射治疗联合（放）化疗能够维持稳定的健康相关生活质量，并在后续一年中观察到症状和生活质量的改善。这些发现将帮助直肠癌患者理解接触式X线近距离放射治疗作为治疗选择的优势与局限性。
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