Longitudinal assessments of quality of life and late toxicities before and after definitive chemoradiation for esophageal cancer.
OBJECTIVE
Definitive chemoradiotherapy is often considered for locally advanced esophageal cancer. We studied the effect of chemoradiotherapy treatment on patients' quality of life and late toxicities.


METHODS
Patients undergoing definitive 5-fluorouracil and cis-diammine-glycolatoplatinum (nedaplatin) therapy concurrent with radiotherapy for esophageal cancer without operation adaptation completed standardized quality-of-life questionnaires before and after chemoradiotherapy and at regular times up to ∼5 years. We analyzed differences in a generic quality-of-life score questionnaire (Functional Assessment of Cancer Therapy-Esophageal scoring) over time by using a linear mixed-effects model.


RESULTS
Longitudinal changes before the start of treatment were able to be evaluated in a total of 80 patients. The quality-of-life score before treatment was worse in patients with advanced stages than those with early stages. The quality-of-life score deteriorated once at the time of 2 or 3 months after starting chemoradiotherapy compared with pre-chemoradiotherapy and recovered and rose higher at 4 or 5 months than before starting chemoradiotherapy. After that, the recovery of quality of life was maintained up to the observation end. The score of physical functioning such as fatigue, nausea/vomiting, pain and dyspnea deteriorated at the time of 2 or 3 months after starting chemoradiotherapy compared with before chemoradiotherapy (80, 86, 94 and 89%).


CONCLUSIONS
The quality-of-life score deteriorates once from before treatment due to acute complications by chemoradiotherapy, but recovers at 4 or 5 months and becomes better than before treatment.
*Division of Radiation Oncology, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan. yamashitah-rad@h.u-tokyo.ac.jp.
Hideomi
H
Yamashita
Mami
M
Omori
Kae
K
Okuma
Reiko
R
Kobayashi
Hiroshi
H
Igaki
Keiichi
K
Nakagawa
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced
D009944:Organoplatinum Compounds; C053989:nedaplatin; D005472:Fluorouracil
FACT-E; chemoradiation; combined modality treatment; esophageal cancer; quality of life