- •We compared health-related quality of life (HRQOL) in patients with rectal cancer having combined modality treatments.
- •Surgery had the most profoundly negative effect on HRQOL across multiple domains.
- •No differences occurred in HRQOL between neoadjuvant strategies, in the first 12 months.
- •HRQOL returned to baseline by 12 months except for body image and sexual functioning.
To assess health-related quality of life (HRQOL) in patients participating in a randomised trial of neoadjuvant short course radiation (SC) or long course chemoradiation (LC) for operable rectal cancer.
Patients and methods
Eligible patients with T3N0-2M0 rectal cancer completed the European Organisation for Research and Treatment of Cancer quality of life questionnaire (QLQ-C30) and the colorectal cancer specific module (QLQ C38) at randomisation and 1, 2, 3, 6, 9 and 12 months later.
Of 326 patients randomised, 297 (SC 143, LC 154) were eligible for completion of HRQOL questionnaires. Baseline scores were comparable across the SC and LC groups. Patients reported low scores on sexual functioning and sexual enjoyment. Defaecation problems were the worst of the symptoms at baseline. Surgery had the most profoundly negative effect on HRQOL, seen in both the SC and LC treatment groups to the same extent. The most severely affected domains were physical function and role function and the most severely affected symptoms were fatigue, pain, appetite, weight loss and male sexual problems. Most domains and symptoms returned to baseline levels by 12 months apart from body image, sexual enjoyment and male sexual problems. Future perspective was better than prior to treatment.
There is no overall difference in HRQOL between SC and LC neoadjuvant treatment strategies, in the first 12 months, after surgery. In the immediate postoperative period HRQOL was adversely affected in both groups but for the most part was temporary. Some residual sexual functioning concerns persisted at 12 months.
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- Preoperative radiotherapy for resectable rectal cancer: a meta-analysis.JAMA. 2000; 284: 1008-1015
- Adjuvant radiotherapy for rectal cancer: a systematic overview of 8,507 patients from 22 randomised trials.Lancet. 2001; 358: 1291-1304
- Randomized trial of short-course radiotherapy versus long-course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer: Trans-Tasman Radiation Oncology Group trial 01.04.J Clin Oncol. 2012; 30: 3827-3833
- The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology.J Natl Cancer Inst. 1993; 85: 365-376
- The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38). European Organization for Research and Treatment of Cancer Study Group on Quality of Life.Eur J Cancer. 1999; 35: 238-247
- EORTC QLQ-C30 scoring manual.European Organisation for Research and Treatment of Cancer, 2001
- Interpreting the significance of changes in health-related quality-of-life scores.J Clin Oncol. 1998; 16: 139-144
- Two-sample tests of area-under-the-curve in the presence of missing data (section 3).Int J Biostat. 2008; 4: 1
- Quality of life after potentially curative treatment for locally advanced rectal cancer.Ann Surg Oncol. 2008; 15: 3109-3117
- Prospective analysis of quality of life and survival following mesorectal excision for rectal cancer.Br J Surg. 2001; 88: 1617-1622
- Sexual (dys)function and the quality of sexual life in patients with colorectal cancer: a systematic review.Ann Oncol. 2012; 23: 19-27
- Psychosexual functioning among adult female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.J Clin Oncol. 2014; 32: 3126-3136
- Impact of short-course preoperative radiotherapy for rectal cancer on patients' quality of life: data from the Medical Research Council CR07/National Cancer Institute of Canada Clinical Trials Group C016 randomized clinical trial.J Clin Oncol. 2010; 28: 4233-4239
- The sexual health care needs after colorectal cancer: the view of patients, partners, and health care professionals.Support Care Cancer. 2014; 22: 763-772
- Urinary and sexual dysfunction in women after resection with and without preoperative radiotherapy for rectal cancer: a population-based cross-sectional study.Colorectal Dis. 2015; 17: 26-37
- Health-related quality of life 14 years after preoperative short-term radiotherapy and total mesorectal excision for rectal cancer: report of a multicenter randomised trial.Eur J Cancer. 2014; 50: 2390-2398
Published online: January 06, 2016
Accepted: October 24, 2015
Received in revised form: October 20, 2015
Received: June 19, 2015
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.