Background and Objectives: Rectal cancer is a major cause of morbidity and mortality worldwide, and although current therapeutic protocols have improved survival, treatment-related toxicities may significantly affect patients’ daily functioning and emotional well-being. This study aimed to prospectively assess the impact of radiotherapy with concurrent capecitabine on functional and symptomatic outcomes in patients with rectal cancer, with a particular focus on the presence of a stoma and treatment strategy. Materials and Methods: From 165 patients initially assessed, 64 were included in this study after applying eligibility criteria. All received pelvic radiotherapy (50.4 Gy in 28 fractions); 62.5% also received CAPOX chemotherapy. The quality of life was assessed using EORTC QLQ-C30 and QLQ-CR29 questionnaires administered at three time points: before treatment, mid-treatment (day 15), and post-treatment. Results: A statistically significant deterioration was observed in physical, emotional, social, and role functioning over the course of treatment, along with an increase in symptom scores for fatigue, pain, gastrointestinal, and urinary complaints. The presence of a stoma was significantly associated with worse gastrointestinal symptoms and emotional functioning. No significant differences were noted between patients with or without chemotherapy. Despite symptom worsening, global quality-of-life scores remained relatively stable. Conclusions: These findings highlight the complex interplay between treatment toxicity and patient adaptation. The presence of a stoma and other clinical or demographic factors significantly influence patients’ experience during therapy. Integrating routine assessment of functional and symptomatic burden into clinical practice could support individualized interventions aimed at maintaining daily functioning and psychological resilience during treatment.
背景与目的：直肠癌是全球范围内导致发病和死亡的主要原因，尽管现有治疗方案已改善患者生存率，但治疗相关毒性可能显著影响患者的日常功能及情绪健康。本研究旨在前瞻性评估放疗联合卡培他滨对直肠癌患者功能与症状结局的影响，特别关注造口存在情况及治疗策略差异。材料与方法：在初步评估的165例患者中，经纳入标准筛选后共64例入组。所有患者均接受盆腔放疗（总剂量50.4 Gy/28次分割），其中62.5%同时接受CAPOX方案化疗。通过EORTC QLQ-C30与QLQ-CR29量表在治疗前、治疗中期（第15天）及治疗后三个时间点评估生活质量。结果：治疗期间患者躯体功能、情绪功能、社会功能及角色功能均出现统计学显著恶化，同时疲劳、疼痛、胃肠道及泌尿系统症状评分显著升高。造口的存在与更严重的胃肠道症状及情绪功能恶化显著相关。化疗与否未导致显著差异。尽管症状加重，总体生活质量评分保持相对稳定。结论：研究结果揭示了治疗毒性与患者适应性之间的复杂相互作用。造口状态及其他临床或人口学因素显著影响患者治疗期间的体验。将功能与症状负担的常规评估纳入临床实践，有助于制定个体化干预措施，从而在治疗期间维持患者的日常功能与心理韧性。
肿瘤(癌症)患者之家