title: Previous radiotherapy negatively influences quality of life during 4 years of follow-up in patients cured from acromegaly.
abstract: OBJECTIVE
  Cross-sectional studies have shown impaired quality of life (QoL) in patients in biochemical control of acromegaly. The aim of this study was to assess longitudinal changes in QoL in a homogenous cohort of patients with sustained biochemical control of acromegaly.
  
  
  METHODS
  Prospective follow-up study.
  
  
  METHODS
  QoL was assessed using four health-related QoL questionnaires (HADS, Hospital Anxiety and Depression Scale; MFI-20, Multidimensional Fatigue Index; NHP, Nottingham Health Profile; and SF-36, Short Form-36) and one disease-specific acromegaly quality of life (ACRO-QOL) questionnaire in 82 patients (43 men) with strict biochemical control of acromegaly, aged 56 years (range 29-84 years) at baseline and after 4 years of follow-up. The mean duration of controlled disease was 12 years (range 1-26 years).
  
  
  RESULTS
  During follow-up, scores in 5 of 26 QoL subscales significantly worsened: physical and social functioning (SF-36), physical fatigue (MFI-20), and psychological well-being and personal relations (ACRO-QOL). Using linear regression analysis, baseline item scores predicted the follow-up scores, indicating individual stability over time. Previous radiotherapy (n = 27, 33%) negatively influenced several QoL subscales at follow-up: energy, pain and social isolation (NHP), physical fatigue and reduction in activity and motivation (MFI-20), depression and total anxiety and depression scores (HADS) and physical performance (ACRO-QOL).
  
  
  CONCLUSIONS
  During 4 years of follow-up in patients with long-term biochemical control of ACRO-QOL is subtly, but progressively impaired. Radiotherapy was the predominant indicator of progressive impairment in QoL.
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands. a.a.van_der_klaauw@lumc.nl
authors.forename: Agatha A
authors.initials: AA
authors.lastname: van der Klaauw
authors.forename: Nienke R
authors.initials: NR
authors.lastname: Biermasz
authors.forename: Hendrieke C
authors.initials: HC
authors.lastname: Hoftijzer
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Pereira
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
mesh_terms: D000172:Acromegaly / Q000523:psychology / Q000532:radiotherapy* / Q000534:rehabilitation*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects*; D012737:Sex Factors; D011795:Surveys and Questionnaires