Highlights
- •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.
Abstract
Purpose
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.
Results
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.
Conclusion
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.
Keywords
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Article info
Publication history
Published online: January 06, 2016
Accepted:
October 24,
2015
Received in revised form:
October 20,
2015
Received:
June 19,
2015
Footnotes
☆ClinicalTrials.gov NCT00351598.
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
