A Systematic Review of Population-Based Studies of Chronic Bowel Symptoms in Cancer Survivors following Pelvic Radiotherapy

Round 1

Reviewer 1 Report

This manuscript addresses highly important issue of post-radiative pelvic bowel problems in cancer patients. It was shown, that data form the prostate-cancer affected are prevalent, while only a few reports describe bowel complications in gynaecologic cancers, with inconsistent tratment modalities and poorer symptoms.

Bowel symptoms were analysed in 45 selected papers. Much attention has been payed to include only bias-free studies. The systematic search results were properly statistically analysed, including broad analytical descriptions.

This manuscript brings deep insight into todays status of bowel complications after radiotherapy in cancer patiens. I highly recommend publishing this meticulous work for the benefit of both the patients and the health providers.

Author Response

We are grateful to Reviewer 1 for taking the time to review this manuscript and for the encouraging feedback provided. 

Reviewer 2 Report

I read with great interest the Manuscript titled " A systematic review of population-based studies of chronic bowel symptoms in cancer survivors following pelvic radiotherapy”, topic interesting enough to attract readers' attention.

Although the manuscript can be considered already of good quality, I would suggest following recommendations: 

-       I suggest a round of language revision, in order to correct few typos and improve readability.

-       It could be useful the evaluation of the impact that the various therapeutic strategies for gynecological cancers,  could have in patients with various comorbidity, older age and the possible application of the frailty index to predict mordidity and mortality. I would be glad if the authors discuss this important point, referring to PMID 33223220. 

Because of these reasons, the article should be revised and completed. Tables are clear and interesting. Considering all these points, I think it could be of interest to the readers and, in my opinion, it deserves the priority to be published after minor revisions.

  I suggest a round of language revision, in order to correct few typos and improve readability

Author Response

We are grateful to the reviewer for the constructive comments received. 

We have undertaken another round of proof reading resulting in some minor corrections and edits, and have changed the spelling to US English. 

We have obtained and read with interest the article to which we were referred (PMID 33223220) and have incorporated reference to this article and its main relevant conclusion within our Discussion section.