title: Activities of daily living and quality of life during treatment with neoadjuvant chemoradiotherapy and after surgery in patients with esophageal cancer.
abstract: OBJECTIVE
  Neoadjuvant chemoradiation (nCRT) followed by esophagectomy is a treatment with curative intent for resectable esophageal cancer. The aim of this study was to measure activities of daily living (ADL) and quality of life (QoL), and to examine correlates of changes in ADL and QoL.
  
  
  METHODS
  A prospective study was performed with three time points (baseline, 1 week after the end of nCRT, 3-months post-surgery) together with a cross-sectional post-treatment study. ADL was measured with the Amsterdam Linear Disability Score (ALDS), and QoL with the EORTC QLQ-C30 and the OES-18. Regression analysis was performed to identify factors associated with changes in ADL and QoL.
  
  
  RESULTS
  Seventy-six patients were included in the prospective study, 79 in the cross-sectional study. After nCRT, ALDS decreased from 90 to 88 (P < 0.01) and remained stable after surgery. Global QoL decreased from 75 to 61 (P < 0.01); no significant changes were observed after surgery. Only timing of the measurement of ALDS was negatively associated with non-maximum ALDS (n = 155, based on both studies) and QoL (n = 76) (P < 0.01).
  
  
  CONCLUSIONS
  Patients who undergo nCRT plus surgery should be prepared to experience a short-term decline in ADL and QoL. The findings of this study can support patients and healthcare workers to guide expectations. J. Surg. Oncol. 2016;114:684-690. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands. n.hajmohammad@amc.nl.|Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. n.hajmohammad@amc.nl.
authors.forename: Nadia
authors.initials: N
authors.lastname: Haj Mohammad
authors.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center Groningen, Groningen, The Netherlands.|Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Sophia
authors.initials: S
authors.lastname: De Rooij
authors.affiliation: Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Hulshof
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Jelle
authors.initials: J
authors.lastname: Ruurda
authors.affiliation: Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Bas
authors.initials: B
authors.lastname: Wijnhoven
authors.affiliation: Department of Internal Medicine, Zuyderland Medisch Centrum, Heerlen/Sittard/Geleen, The Netherlands.
authors.forename: Frans
authors.initials: F
authors.lastname: Erdkamp
authors.affiliation: Department of Surgery, Zuyderland Medisch Centrum, Heerlen/Sittard/Geleen, The Netherlands.
authors.forename: Meindert
authors.initials: M
authors.lastname: Sosef
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Gisbertz
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: van Berge Henegouwen
authors.affiliation: Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Sprangers
authors.affiliation: Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Hanneke
authors.initials: H
authors.lastname: van Laarhoven
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D059186:Chemoradiotherapy, Adjuvant; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004938:Esophageal Neoplasms / Q000628:therapy*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017239:Paclitaxel / Q000627:therapeutic use; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel
keywords: activities of daily living; esophageal cancer; neoadjuvant chemoradiotherapy; quality of life; surgery