NDLI: Intensified neoadjuvant chemoradiotherapy in locally advanced rectal cancer -- impact on long-term quality of life.

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Intensified neoadjuvant chemoradiotherapy in locally advanced rectal cancer -- impact on long-term quality of life.

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Intensified neoadjuvant chemoradiotherapy in locally advanced rectal cancer -- impact on long-term quality of life.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kripp, M. Wieneke, J. Kienle, P. Welzel, G. Brade, J. Horisberger, K. Wenz, F. Post, S. Gencer, D. Hofmann, W. K. Hofheinz, R-D
Description	Country affiliation: Germany Author Affiliation: Kripp M ( III. Medizinische Klinik, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer Ufer 1-3, 68167 Mannheim, Germany. melanie.kripp@umm.de)
Abstract	AIMS: In spite of advances in rectal cancer surgery and the use of preoperative 5-fluorouracil-(5-FU) based chemoradiotherapy (CRT) in stage II and III disease distant metastases still occur in about 35-40% of the patients. Intensified preoperative CRT (ICRT) using other drugs in conjunction with 5-FU has been investigated in order to improve the pathological complete remission (pCR) rate and thereby prognosis of patients with locally advanced rectal cancer. However, acute toxicity, especially diarrhea, was reported to be high and no improvement in pCR rates has been observed in randomized trials. Long-term results of these trials are pending. In the present analysis we investigated the impact of ICRT on health related quality of life and long term toxicity. METHODS: The present study included 119 patients with locally advanced rectal cancer who underwent neoadjuvant CRT followed by surgery within controlled clinical trials. Patients received ICRT (n = 83) or standard CRT (n = 36). Evaluation of HRQoL was performed using EORTC QLQ-C30 and QLQ-CR29 questionnaires. RESULTS: The overall rating of global health status/QLQ scale of the EORTC QLQ-C30 questionnaire was identical in both patient groups but patients in the CRT group showed better results in four out of nine function scales. Concerning symptom scales, patients in the CRT arm exhibited significantly less diarrhea (p = 0.028) and less disorders with taste (0.042). CONCLUSIONS: This data suggests that higher gastrointestinal acute toxicity caused by ICRT might lead to a higher risk of long-term deterioration of 'gastrointestinal QoL'. Future results of randomized trials investigating ICRT versus CRT should be discussed in the light of long-term QoL data.
File Format	HTM / HTML
ISSN	07487983
Issue Number	6
Volume Number	38
e-ISSN	15322157
Journal	European Journal of Surgical Oncology (EJSO)
Language	English
Publisher	Elsevier
Publisher Date	2012-06-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline General Surgery Discipline Oncology Adenocarcinoma Pathology Therapy Antineoplastic Combined Chemotherapy Protocols Therapeutic Use Neoadjuvant Therapy Methods Quality Of Life Rectal Neoplasms Adult Aged Aged, 80 And Over Chemoradiotherapy, Adjuvant Clinical Trials, Phase I As Topic Clinical Trials, Phase Ii As Topic Clinical Trials, Phase Iii As Topic Confounding Factors (epidemiology) Diarrhea Etiology Female Fluorouracil Administration & Dosage Gastrointestinal Tract Drug Effects Radiation Effects Health Status Humans Male Middle Aged Neoplasm Staging Questionnaires Treatment Outcome Comparative Study Journal Article
Content Type	Text
Resource Type	Article
Subject	Surgery Oncology

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