| Literature DB >> 29161204 |
Bo Jan Noordman1, Mathilde G E Verdam1, Sjoerd M Lagarde1, Maarten C C M Hulshof1, Pieter van Hagen1, Mark I van Berge Henegouwen1, Bas P L Wijnhoven1, Hanneke W M van Laarhoven1, Grard A P Nieuwenhuijzen1, Geke A P Hospers1, Johannes J Bonenkamp1, Miguel A Cuesta1, Reinoud J B Blaisse1, Olivier R Busch1, Fiebo J W Ten Kate1, Geert-Jan M Creemers1, Cornelis J A Punt1, John Th M Plukker1, Henk M W Verheul1, Ernst J Spillenaar Bilgen1, Herman van Dekken1, Maurice J C van der Sangen1, Tom Rozema1, Katharina Biermann1, Jannet C Beukema1, Anna H M Piet1, Caroline M van Rij1, Janny G Reinders1, Hugo W Tilanus1, Ewout W Steyerberg1, Ate van der Gaast1, Mirjam A G Sprangers1, J Jan B van Lanschot1.
Abstract
Purpose To compare pre-agreed health-related quality of life (HRQOL) domains in patients with esophageal or junctional cancer who received neoadjuvant chemoradiotherapy (nCRT) followed by surgery or surgery alone. Secondary aims were to examine the effect of nCRT on HRQOL before surgery and the effect of surgery on HRQOL. Patients and Methods Patients were randomly assigned to nCRT (carboplatin plus paclitaxel with concurrent 41.4-Gy radiotherapy) followed by surgery or surgery alone. HRQOL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) and -Oesophageal Cancer Module (QLQ-OES24) questionnaires pretreatment and at 3, 6, 9, and 12 months postoperatively. The nCRT group also received preoperative questionnaires. Physical functioning (PF; QLQ-C30) and eating problems (EA; QLQ-OES24) were chosen as predefined primary end points. Predefined secondary end points were global QOL (GQOL; QLQ-C30), fatigue (FA; QLQ-C30), and emotional problems (EM; QLQ-OES24). Results A total of 363 patients were analyzed. No statistically significant differences in postoperative HRQOL were found between treatment groups. In the nCRT group, PF, EA, GQOL, FA, and EM scores deteriorated 1 week after nCRT (Cohen's d: -0.93, P < .001; 0.47, P < .001; -0.84, P < .001; 1.45, P < .001; and 0.32, P = .001, respectively). In both treatment groups, all end points declined 3 months postoperatively compared with baseline (Cohen's d: -1.00, 0.33, -0.47, -0.34, and 0.33, respectively; all P < .001), followed by a continuous gradual improvement. EA, GQOL, and EM were restored to baseline levels during follow-up, whereas PF and FA remained impaired 1 year postoperatively (Cohen's d: 0.52 and -0.53, respectively; both P < .001). Conclusion Although HRQOL declined during nCRT, no effect of nCRT was apparent on postoperative HRQOL compared with surgery alone. In addition to the improvement in survival, these findings support the view that nCRT according to the Chemoradiotherapy for Esophageal Cancer Followed by Surgery Study-regimen can be regarded as a standard of care.Entities:
Mesh：
Substances：
Year: 2017 PMID： 29161204 DOI： 10.1200/JCO.2017.73.7718
Source DB: PubMed Journal: J Clin Oncol ISSN： 0732-183X Impact factor: 44.544