title: The impact on health-related quality of life in the first 12 months: A randomised comparison of preoperative short-course radiation versus long-course chemoradiation for T3 rectal cancer (Trans-Tasman Radiation Oncology Group Trial 01.04).
abstract: OBJECTIVE
  To assess health-related quality of life (HRQOL) in patients participating in a randomised trial of neoadjuvant short course radiation (SC) or long course chemoradiation (LC) for operable rectal cancer.
  
  
  METHODS
  Eligible patients with T3N0-2M0 rectal cancer completed the European Organisation for Research and Treatment of Cancer quality of life questionnaire (QLQ-C30) and the colorectal cancer specific module (QLQ C38) at randomisation and 1, 2, 3, 6, 9 and 12 months later.
  
  
  RESULTS
  Of 326 patients randomised, 297 (SC 143, LC 154) were eligible for completion of HRQOL questionnaires. Baseline scores were comparable across the SC and LC groups. Patients reported low scores on sexual functioning and sexual enjoyment. Defaecation problems were the worst of the symptoms at baseline. Surgery had the most profoundly negative effect on HRQOL, seen in both the SC and LC treatment groups to the same extent. The most severely affected domains were physical function and role function and the most severely affected symptoms were fatigue, pain, appetite, weight loss and male sexual problems. Most domains and symptoms returned to baseline levels by 12 months apart from body image, sexual enjoyment and male sexual problems. Future perspective was better than prior to treatment.
  
  
  CONCLUSIONS
  There is no overall difference in HRQOL between SC and LC neoadjuvant treatment strategies, in the first 12 months, after surgery. In the immediate postoperative period HRQOL was adversely affected in both groups but for the most part was temporary. Some residual sexual functioning concerns persisted at 12 months.
authors.affiliation: Peter MacCallum Cancer Centre, Australia; St Vincent's Hospital, Fitzroy, Australia; The University of Melbourne, Parkville, Australia. Electronic address: sue-anne.mclachlan@svhm.org.au.
authors.forename: Sue-Anne
authors.initials: SA
authors.lastname: McLachlan
authors.affiliation: Peter MacCallum Cancer Centre, Australia; The University of Melbourne, Parkville, Australia.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Fisher
authors.affiliation: Peter MacCallum Cancer Centre, Australia; The University of Melbourne, Parkville, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Zalcberg
authors.affiliation: Royal Prince Alfred Hospital, Newtown, Australia; University of Sydney, Sydney, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Solomon
authors.affiliation: Princess Alexandra Hospital, Woolloongabba, Australia; The University of Queensland, Brisbane, Australia.
authors.forename: Bryan
authors.initials: B
authors.lastname: Burmeister
authors.affiliation: Prince of Wales Hospital, Randwick, Australia; The University of New South Wales, Kensington, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
authors.affiliation: Peter MacCallum Cancer Centre, Australia; The University of Melbourne, Parkville, Australia.
authors.forename: Trevor
authors.initials: T
authors.lastname: Leong
authors.affiliation: Calvary Mater Hospital, Newcastle, Australia; The University of Newcastle, Callaghan, Australia.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Ackland
authors.affiliation: Box Hill Hospital, Box Hill, Australia; Monash University, Clayton, Australia.
authors.forename: Joseph
authors.initials: J
authors.lastname: McKendrick
authors.affiliation: Peter MacCallum Cancer Centre, Australia.
authors.forename: Bev
authors.initials: B
authors.lastname: McClure
authors.affiliation: Peter MacCallum Cancer Centre, Australia; The University of Melbourne, Parkville, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Mackay
authors.affiliation: Peter MacCallum Cancer Centre, Australia; The University of Melbourne, Parkville, Australia.
authors.forename: Samuel Y
authors.initials: SY
authors.lastname: Ngan
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects / Q000523:psychology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000523:psychology; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D011832:Radiation Injuries / Q000503:physiopathology / Q000523:psychology; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D012307:Risk Factors; D012725:Sexual Behavior; D012919:Social Behavior; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: Health-related quality of life; Neoadjuvant chemoradiation; Rectal cancer