title: Long-term quality-of-life after neoadjuvant short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer.
abstract: OBJECTIVE
  To evaluate long-term quality-of-life (QoL) after neoadjuvant short-course radiotherapy (SC-RT) and long-course radiochemotherapy (LC-RCHT) for locally advanced rectal cancer.
  
  
  METHODS
  Between 1999 and 2008, 225 patients were treated with curative intent for locally advanced rectal cancer using neoadjuvant SC-RT (n=108) or LC-RCHT (n=117). SC-RT delivered 10 × 2.9 Gy twice daily with immediate surgery. LC-RCHT delivered 28 × 1.8 Gy concomitant with 5-FU based chemotherapy and delayed surgery. A cross-sectional QoL analysis was performed in disease-free patients using the EORTC-QLQ-C30 and EORTC-QLQ-CR29 questionnaires.
  
  
  RESULTS
  After a median follow-up of 67 months, 133 patients were disease-free of which 120 (90%) returned the QoL questionnaires. Patients in the LC-RCHT cohort had a higher rate of uT4, uN+ and low tumor location. No difference in QoL was observed between SC-RT and LC-RCHT except an improved physical functioning in the LC-RCHT group (p=0.04). Comparing our total patient cohort with the general German population showed no difference in global health status but decreased QoL in several functional and bowel symptom scores.
  
  
  CONCLUSIONS
  The finding of comparable long-term QoL after SC-RT and LC-RCHT adds to our knowledge of equivalent oncological outcome and may be useful in the decision making process between the two neoadjuvant approaches.
authors.affiliation: Department of Radiation Oncology, University of Wuerzburg, Germany. Electronic address: Guckenberger_M@klinik.uni-wuerzburg.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Guckenberger
authors.forename: Gabriella
authors.initials: G
authors.lastname: Saur
authors.forename: Daniel
authors.initials: D
authors.lastname: Wehner
authors.forename: Andreas
authors.initials: A
authors.lastname: Thalheimer
authors.forename: Mia
authors.initials: M
authors.lastname: Kim
authors.forename: Christoph-Thomas
authors.initials: CT
authors.lastname: Germer
authors.forename: Michael
authors.initials: M
authors.lastname: Flentje
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000379:methods*; D003430:Cross-Sectional Studies; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018570:Risk Assessment; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005472:Fluorouracil
keywords: Long course radiochemotherapy; Neoadjuvant; Quality-of-life; Rectal cancer; Short course radiotherapy