Health-related quality of life in rectal cancer patients undergoing neoadjuvant chemoradiation with delayed surgery versus short-course radiotherapy with immediate surgery : a propensity score-matched cohort study
| Autor: | A. H. W. Schiphorst, Niels A.T. Wijffels, Esther C. J. Consten, Joost T. Heikens, Alice M. Couwenberg, Miriam Koopman, Wilhemina M.U. van Grevenstein, Martijn Intven, J.P.M. Burbach, Helena M. Verkooijen, Anke B. Smits |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Colorectal cancer medicine.medical_treatment 030218 nuclear medicine & medical imaging 0302 clinical medicine Quality of life 80 and over Adjuvant/methods Prospective Studies Prospective cohort study Neoadjuvant therapy Digestive System Surgical Procedures Aged 80 and over General Medicine Chemoradiotherapy Hematology Middle Aged Prognosis Combined Modality Therapy Neoadjuvant Therapy Digestive System Surgical Procedures/methods Radiotherapy/methods Oncology Radiology Nuclear Medicine and imaging 030220 oncology & carcinogenesis Female Adult medicine.medical_specialty Chemoradiotherapy Adjuvant/methods 03 medical and health sciences medicine Journal Article Humans Radiology Nuclear Medicine and imaging Comparative Study Propensity Score Aged Radiotherapy business.industry Rectal Neoplasms Chemoradiotherapy Adjuvant medicine.disease Surgery Radiation therapy Propensity score matching Quality of Life Rectal Neoplasms/pathology business Follow-Up Studies |
| Zdroj: | Acta Oncologica, 58(4), 407. Informa Healthcare |
| ISSN: | 0284-186X |
| Popis: | Background: Neoadjuvant chemoradiation with delayed surgery (CRT-DS) and short-course radiotherapy with immediate surgery (SCRT-IS) are two commonly used treatment strategies for rectal cancer. However, the optimal treatment strategy for patients with intermediate-risk rectal cancer remains a discussion. This study compares quality of life (QOL) between SCRT-IS and CRT-DS from diagnosis until 24 months after treatment. Methods: In a prospective colorectal cancer cohort, rectal cancer patients with clinical stage T2-3N0-2M0 undergoing SCRT-IS or CRT-DS between 2013 and 2017 were identified. QOL was assessed using EORTC-C30 and EORTC-CR29 questionnaires before the start of neoadjuvant treatment (baseline) and at 3, 6, 12, 18 and 24 months after. Patients were 1:1 matched using propensity sore matching. Between- and within-group differences in QOL domains were analyzed with linear mixed-effects models. Symptoms and sexual interest at 12 and 24 months were compared using logistic regression models. Results: 156 of 225 patients (69%) remained after matching. The CRT-DS group reported poorer emotional functioning at 3, 6, 12, 18 and 24 months (mean difference with SCRT-IS: −9.4, −12.1, −7.3, −8.0 and −7.9 respectively), and poorer global health, physical-, role-, social- and cognitive functioning at 6 months (mean difference with SCRT-IS: −9.1, −9.8, −14.0, −9.2 and −12.6, respectively). Besides emotional functioning, all QOL domains were comparable at 12, 18 and 24 months. Within-group changes showed a significant improvement of emotional functioning after baseline in the SCRT-IS group, whereas only a minor improvement was observed in the CRT-DS group. Symptoms and sexual interest in male patients at 12 and 24 months were comparable between the groups. Conclusions: In rectal cancer patients, CRT-DS may induce a stronger decline in short-term QOL than SCRT-IS. From 12 months onwards, QOL domains, symptoms and sexual interest in male patients were comparable between the groups. However, emotional functioning remained higher after SCRT-IS than after CRT-DS. |
| Databáze: | OpenAIRE |
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