title: Health-related quality of life (HRQoL) after multimodal treatment for primarily non-resectable rectal cancer. Long-term results from a phase III study.
abstract: BACKGROUND
  A randomised study in non-resectable rectal cancer showed that preoperative chemoradiotherapy (CRT) resulted in better local control and disease-specific survival, but not overall survival than radiotherapy alone. The present paper presents long-term (>4 years) health-related quality of life (HRQoL) and a comparison between the results and reference values from the Norwegian general population.
  
  
  METHODS
  A total of 207 patients with primarily non-resectable rectal cancer were randomised to preoperative CRT (2Gyx25+5FU/leucovorin) or RT (2Gyx25) before surgery. HRQoL was assessed using EORTC QLQ-C30, completed at baseline and sent to all patients alive in Norway and Sweden (n=105) after a minimum of 4 years post treatment. A difference of ≥5 points on the 0-100 scales was considered clinically significant.
  
  
  RESULTS
  Seventy-six (72%) patients answered at follow-up. No statistically significant differences between the CRT and RT groups appeared at follow-up, although clinically significant differences in social functioning, dyspnoea and diarrhoea were found. Over time, a clinically significant reduction in physical functioning was found in both groups. Moreover, reduced social functioning and less diarrhoea in the CRT group and better role functioning and more diarrhoea in the RT group were found. Comparisons between the study group and age and gender matched reference values indicate impaired social functioning and more diarrhoea among the patients.
  
  
  CONCLUSIONS
  There were no statistically significant differences in HRQoL between the randomisation groups. In general, despite having impaired social functioning and more diarrhoea, patients reported HRQoL comparable with the reference population several years after treatment.
authors.affiliation: Dept. of Oncology, Oslo University Hospital, Oslo, Norway. mortbrae@medisin.uio.no
authors.forename: Morten
authors.initials: M
authors.lastname: Brændengen
authors.forename: Kjell M
authors.initials: KM
authors.lastname: Tveit
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Hjermstad
authors.forename: Hemming
authors.initials: H
authors.lastname: Johansson
authors.forename: Åke
authors.initials: Å
authors.lastname: Berglund
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Brandberg
authors.forename: Bengt
authors.initials: B
authors.lastname: Glimelius
mesh_terms: D000230:Adenocarcinoma / Q000523:psychology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000379:methods; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D011044:Poland; D011300:Preoperative Care; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000523:psychology / Q000532:radiotherapy*; D013548:Sweden