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Quality of life across chemotherapy lines in patients with advanced colorectal cancer: a prospective single-center observational study

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Abstract

Background

Palliative chemotherapy in patients with nonresectable advanced colorectal carcinoma is performed to prolong survival, alleviate tumor-associated symptoms, and maintain or improve health-related quality of life (HRQOL). In this prospective single-center observational study, we assessed HRQOL across the various lines of palliative chemotherapy.

Methods

HRQOL data were acquired using the EORTC Quality of Life Questionnaire-C30 (QLQ-C30) questionnaire. The first assessment was performed at the beginning of each chemotherapy line, the second after three cycles, and the third at the end of chemotherapy. Further assessments were conducted during checkups every 3 months in our outpatient unit.

Results

In total, 100 consecutive patients with colorectal carcinoma (mean age 66.4 years; 60 % men) treated with palliative chemotherapy were recruited. Generally, QOL deteriorated constantly across time. Physical functioning, fatigue, pain, dyspnea, and appetite worsened steadily from first-line chemotherapy to the later treatment phase. Global QOL, emotional functioning, and role functioning improved slightly after the end of first-line chemotherapy, deteriorated during second-line chemotherapy to the level of first-line chemotherapy, and further deteriorated in the later treatment phases. In additional analyses, we found the largest differences between patients with and without a treatment response for pain (19.0 vs. 37.2 points) and appetite loss (17.4 vs. 32.7 points).

Conclusion

The individual QOL domains deteriorated constantly across time. Our data indicate that patients undergoing first- and second-line palliative chemotherapy experience stabilization of global QOL and psychosocial symptoms. We also found that unselected patients who achieved a treatment response had a lower symptom burden and better QOL than did patients with progressive disease.

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Acknowledgments

We would like to thank Bettina Buchbauer Mag, MSc. and Ina Pühringer Mag, MSc for their contribution to the data collection.

Funding

The study was partly funded by the Forschungsförderungsverein Oberösterreichische Krebshilfe, an independent and non-profit association with the aim of cancer research, cancer prevention, and counseling. The funding source had no involvement in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Grieskirchnerstraße 42, 4600, Wels, Austria

    Beate Mayrbäurl, Sonja Burgstaller, Gudrun Piringer & Josef Thaler

  2. Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Anichstrasse 35, A-6020, Innsbruck, Austria

    Johannes M. Giesinger & Bernhard Holzner

Authors
  1. Beate Mayrbäurl
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  2. Johannes M. Giesinger
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  4. Gudrun Piringer
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  5. Bernhard Holzner
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  6. Josef Thaler
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Correspondence to Beate Mayrbäurl.

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Mayrbäurl, B., Giesinger, J.M., Burgstaller, S. et al. Quality of life across chemotherapy lines in patients with advanced colorectal cancer: a prospective single-center observational study. Support Care Cancer 24, 667–674 (2016). https://doi.org/10.1007/s00520-015-2828-0

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  • DOI: https://doi.org/10.1007/s00520-015-2828-0

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