Supportive Care in Cancer

, Volume 21, Issue 4, pp 1193–1199 | Cite as

Assessment of patient-reported measures of bowel function before and after pelvic radiotherapy: an ancillary study of the North Central Cancer Treatment Group study N00CA

  • Pamela J. Atherton
  • Michele Y. Halyard
  • Jeff A. Sloan
  • Robert C. Miller
  • Richard L. Deming
  • T. H. Patricia Tai
  • Kathy J. Stien
  • James A. MartensonJr.Email author
Original Article



The Bowel Function Questionnaire (BFQ) has been used in clinical trials to assess symptoms during and after pelvic radiotherapy (RT). This study evaluated the importance of symptoms in the BFQ from a patient perspective.


Patients reported presence or absence of symptoms and rated importance of symptoms at baseline, 4 weeks after completion of pelvic RT, and 12 and 24 months after RT. The BFQ measured overall quality of life (QOL) and symptoms of nocturnal bowel movements, incontinence, clustering, need for protective clothing, inability to differentiate stool from gas, liquid bowel movements, urgency, cramping, and bleeding. Bowel movement frequency also was recorded. A content validity questionnaire (CVQ) was used to rate symptoms as “not very important,” “moderately unimportant,” “neutral,” “moderately important,” or “very important.”


Most of the 125 participating patients rated all symptoms as moderately or very important. Generally, patients gave similar ratings for symptom importance at all study points, and ratings were independent of whether the patient experienced the symptom. Measures of greatest importance (moderately or very important) at baseline were ability to control bowel movements (94 %), not having to wear protective clothing (90 %), and not having rectal bleeding (94 %). With the exception of need for protective clothing, the presence of a symptom at 4 weeks was associated with significantly worse QOL (P < .01 for all).


The BFQ has excellent content validity. Patients rated most symptoms as moderately or very important, indicating the BFQ is an appropriate tool for symptom assessment during and after pelvic RT.


Bowel function Content validity Pelvic radiotherapy Quality of life 



Bowel function questionnaire


Content validity questionnaire


North Central Cancer Treatment Group


Pelvic radiotherapy


Quality of life



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 CA-25224, CA-60276, CA-35101, CA-35103, CA-35415, CA-35431, CA-63849, CA-35269, CA-35119, CA-37417, CA-35267, CA-52654, and CA-35195.

Additional institutions that enrolled patients in this study included: Duluth CCOP, Duluth, MN, USA (Daniel A. Nikcevich, MD); Mayo Clinic, Jacksonville, FL, USA (Kurt A. Jaeckle, MD); Sioux Community Cancer Consortium, Sioux Falls, SD, USA (Miroslaw Mazurczak, MD); Spartanburg Regional Medical Center, Spartanburg, SC, USA (James D. Bearden, III, MD); Meritcare Hospital CCOP, Fargo, ND, USA (Preston D. Steen, MD); Metro-Minnesota Community Clinical Oncology Program, St. Louis Park, MN, USA (Patrick J. Flynn, MD); Carle Cancer Center CCOP, Urbana, IL, USA (Kendrith M. Rowland, Jr, MD); Montana Cancer Consortium, Billings, MT, USA (Benjamin T. Marchello, MD); and Wichita Community Clinical Oncology Program, Wichita, KS, USA (Shaker R. Dakhil, MD).

Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Pamela J. Atherton
    • 1
  • Michele Y. Halyard
    • 4
  • Jeff A. Sloan
    • 1
  • Robert C. Miller
    • 2
  • Richard L. Deming
    • 5
  • T. H. Patricia Tai
    • 6
  • Kathy J. Stien
    • 3
  • James A. MartensonJr.
    • 2
    Email author
  1. 1.Division of Biomedical Statistics and InformaticsMayo ClinicRochesterUSA
  2. 2.Department of Radiation OncologyMayo ClinicRochesterUSA
  3. 3.Department of Neurologic SurgeryMayo ClinicRochesterUSA
  4. 4.Department of Radiation OncologyMayo ClinicScottsdaleUSA
  5. 5.Department of Radiation OncologyIowa Oncology Research Association CCOPDes MoinesUSA
  6. 6.Allan Blair Cancer CentreReginaCanada

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