Health status and quality of life in patients with early-stage Hodgkin's disease treated on Southwest Oncology Group Study 9133.
OBJECTIVE
We describe the short and intermediate-term quality-of-life (QOL) outcomes in patients treated on a randomized clinical trial in early-stage Hodgkin's disease (Southwest Oncology Group [SWOG] 9133) comparing subtotal lymphoid irradiation (STLI) with combined-modality treatment (CMT).


METHODS
Two hundred forty-seven patients participated in the QOL study (SWOG 9208), completing several standardized instruments (Symptom Distress Scale; Cancer Rehabilitation Evaluation System - Short Form; Medical Outcomes Study 36-Item Short-Form Health Survey Vitality Scale; and a health perception item), as well as questions about work, marital status, and concerns about having children. This article reports on results from baseline before random assignment, at 6 months, and at 1 and 2 years after random assignment.


RESULTS
Patients receiving CMT experienced significantly greater symptom distress (P = .0001), [corrected] fatigue (P =.0001), [corrected] and poorer QOL (P =.015) at 6 months than the STLI patients, reflecting a shorter time since completion of therapy in the CMT arm. Importantly, patients in the two groups did not differ on any outcomes at the 1-and 2-year assessments. The study cohort at randomization exhibited more fatigue [corrected] than healthy reference populations. Fatigue levels did not exceed baseline estimates by the end of the study. [corrected].


CONCLUSIONS
This study demonstrated that patients with early-stage Hodgkin's disease experience a short-term decrease in QOL and an increase in symptoms and fatigue with treatment, which is more severe with CMT; by 1 year, however, CMT and STLI patients report similar outcomes. Fatigue scores for both arms were lower at baseline than scores for the general population and did not return to normal levels 2 years after random assignment. The mechanisms responsible for this lingering problem warrant further investigation.
Ganz
Patricia A
PA
University of California, Los Angeles, Los Angeles, CA, USA.
Moinpour
Carol M
CM
Pauler
Donna K
DK
Kornblith
Alice B
AB
Gaynor
Ellen R
ER
Balcerzak
Stanley P
SP
Gatti
Gretchen S
GS
Erba
Harry P
HP
McCoy
Sheryl
S
Press
Oliver W
OW
Fisher
Richard I
RI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006304:Health Status; D006689:Hodgkin Disease / Q000628:therapy*; D006801:Humans; D015182:Lymphatic Irradiation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011879:Radiotherapy Dosage; D011795:Surveys and Questionnaires