Quality of Life During Neoadjuvant Treatment and After Surgery for Resectable Esophageal Carcinoma
Purpose: Because of the trade-off between the potentially negative quality-of-life (QoL) effects and uncertain favorable survival effect of neoadjuvant chemoradiotherapy (CRT) in patients with resectable esophageal cancer, we assessed heath-related QoL (HRQoL) for up to 1 year postoperatively in these patients treated with preoperative CRT with a non-platinum-based outpatient regimen followed by esophagectomy. Methods and Materials: Patients undergoing neoadjuvant paclitaxel and carboplatin therapy concurrent with radiotherapy followed by surgery completed standardized HRQoL questionnaires before and after CRT and at regular times up to 1 year postoperatively. We analyzed differences in generic Qol core questionnaire [QLQ-C30] and condition-specific (esophageal site-specific [OES-18]) HRQoL scores over time by using a linear mixed-effects model. Results: Mean scores of most HRQoL scales deteriorated significantly during neoadjuvant CRT. The largest deterioration was observed for physical and role-functioning scales. All except two symptom scores worsened significantly. Postoperatively, most mean HRQoL scores improved until recovery to baseline level. Speed of improvement varied. Average taste score returned to baseline 3 months postoperatively, whereas it took 1 year for the average role-functioning score to restore. The emotional-functioning score showed a different pattern; it was worst at baseline and increased over time during CRT and postoperatively. Dysphagia and pain scores worsened considerably during CRT, restored to baseline 3 months postoperatively, and were even significantly better 1 year postoperatively. Conclusions: Preoperative CRT with paclitaxel and carboplatin for patients with resectable esophageal cancer had a considerable temporary negative effect on most aspects of HRQoL. Nonetheless, all HRQoL scores were restored or even improved 1 year postoperatively.
|Keywords||Combined-modality treatment, Esophageal cancer, Esophagectomy, Health-related quality of life, Neoadjuvant chemoradiotherapy|
|Persistent URL||dx.doi.org/10.1016/j.ijrobp.2007.09.038, hdl.handle.net/1765/29633|
|Journal||International Journal of Radiation: Oncology - Biology - Physics|
van Meerten, E, van der Gaast, A, Looman, C.W.N, Tilanus, H.W, Muller, K, & Essink-Bot, M.L.E. (2008). Quality of Life During Neoadjuvant Treatment and After Surgery for Resectable Esophageal Carcinoma. International Journal of Radiation: Oncology - Biology - Physics, 71(1), 160–166. doi:10.1016/j.ijrobp.2007.09.038