Carol M Moinpour1,2, Joseph M Unger3,4, Patricia A Ganz5, Alice B Kornblith6, Ellen R Gaynor7, Mindy Ann Bowers8, Gretchen S Gatti9, Mark S Kaminski10, Harry Paul Erba11, Ting Wang12, Jihye Yoon13, Oliver W Press14, Richard I Fisher15. 1. Public Health Sciences Division, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, M3-C102/P.O. Box 19024, 1100 Fairview Avenue North, Seattle, WA, 98109-1024, USA. cmoinpou@fredhutch.org. 2. School of Public Health, University of Washington, Seattle, WA, USA. cmoinpou@fredhutch.org. 3. Public Health Sciences Division, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, M3-C102/P.O. Box 19024, 1100 Fairview Avenue North, Seattle, WA, 98109-1024, USA. 4. School of Public Health, University of Washington, Seattle, WA, USA. 5. UCLA Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA. 6. , 140 8th Ave, Apt4-O, Brooklyn, NY, USA. 7. Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University, Maywood, IL, USA. 8. Division of Nephrology, Nephrology Clinical Trials Unit, The Ohio State University, Columbus, OH, USA. 9. Mark H. Zangmeister Center, Columbus CCOP, Columbus, OH, USA. 10. Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA. 11. Division of Hematology/Oncology, The Kirklin Clinic-Birmingham, Birmingham, AL, USA. 12. Educational Psychology Dept. (PhD program), College of Education, University of Washington, Seattle, WA, USA. 13. Public Health Sciences Division, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA, USA. 14. Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA, USA. 15. Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA, USA.
Abstract
PURPOSE: We describe 7 years of follow-up for the energy/vitality outcome in early-stage Hodgkin's disease patients treated on a randomized clinical trial that compared subtotal lymphoid irradiation (STLI) with combined modality treatment (CMT) (SWOG 9133). Survivorship research questions involved the extent to which symptoms/side effects endured over a follow-up period of 7 years for this early-stage patient group. METHODS:Two hundred thirty-nine patients participated in thequality of life (QOL) companion study (SWOG 9208) and completed the SF-36 vitality scale, SF-36 health perception item, Cancer Rehabilitation Evaluation System-Short Form (CARES-SF), and symptom distress scale. This paper reports vitality outcome results obtained from randomization, 6 months, and annually for 7 years. To assess changes in vitality over time, we used linear mixed models with patient as a random effect. RESULTS: Patients receiving CMT had lower observed vitality at 6 months than did the STLI patients (p < .0001). However, beginning at year 1, vitality results did not differ significantly by treatment over the 5-year (p = .13) and 7-year (p = .16) follow-up periods. Vitality only slightly improved over baseline in either group after treatment. The results were similar after accounting for patterns of recurrence and missing data. CONCLUSIONS: This study demonstrated that patients with early-stage Hodgkin's disease experience a short-term (at 6 months) decrease in vitality with treatment, which is more severe with CMT, but that after the first year, vitality scores were similar between the two treatment groups. Enduring fatigue results for patients receiving these therapies were not observed. Implications for cancer survivors These data provide comprehensive 7-year follow-up vitality information, an important symptom for early-stage lymphoma survivors.
RCT Entities:
PURPOSE: We describe 7 years of follow-up for the energy/vitality outcome in early-stage Hodgkin's diseasepatients treated on a randomized clinical trial that compared subtotal lymphoid irradiation (STLI) with combined modality treatment (CMT) (SWOG 9133). Survivorship research questions involved the extent to which symptoms/side effects endured over a follow-up period of 7 years for this early-stage patient group. METHODS: Two hundred thirty-nine patients participated in the quality of life (QOL) companion study (SWOG 9208) and completed the SF-36 vitality scale, SF-36 health perception item, Cancer Rehabilitation Evaluation System-Short Form (CARES-SF), and symptom distress scale. This paper reports vitality outcome results obtained from randomization, 6 months, and annually for 7 years. To assess changes in vitality over time, we used linear mixed models with patient as a random effect. RESULTS:Patients receiving CMT had lower observed vitality at 6 months than did the STLIpatients (p < .0001). However, beginning at year 1, vitality results did not differ significantly by treatment over the 5-year (p = .13) and 7-year (p = .16) follow-up periods. Vitality only slightly improved over baseline in either group after treatment. The results were similar after accounting for patterns of recurrence and missing data. CONCLUSIONS: This study demonstrated that patients with early-stage Hodgkin's disease experience a short-term (at 6 months) decrease in vitality with treatment, which is more severe with CMT, but that after the first year, vitality scores were similar between the two treatment groups. Enduring fatigue results for patients receiving these therapies were not observed. Implications for cancer survivors These data provide comprehensive 7-year follow-up vitality information, an important symptom for early-stage lymphoma survivors.
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