Impact of Adjuvant Chemoradiotherapy for Rectal Cancer on the Long-Term Quality of Life and Late Side Effects: A Multicentric Clinical Evaluation by the Turkish Oncology Group

Abstract

Aim: Although preoperative chemoradiatherapy (CRT) has proven its benefits in terms of decreased toxicity, there is still a considerable amount of cases that do not receive postoperative CRT. Oncologists at different geographic locations still need to know the long-term effects of this treatment in order to manage patients successfully. The current paper reports on long-term quality of life (QOL) and late side effects after adjuvant CRT in rectal cancer patients from 5 centers in Anatolia. Methods: Rectal cancer patients treated with postoperative CRT with minimum 1-year follow-up and were in complete remission, were evaluated according to RTOG and LENT-SOMA scales. They were also asked to complete Turkish version of EORTC QLQ-C30 questionnaire and the CR-38 module. Each center participated with the required clinical data. Results: Two hundred and thirty patients with median age of 55 years participated and completed the study. Median follow-up time was 5 years. All patients received RT concomitant with chemotherapy. Common parameters that both increased functional health scales and yielded better symptom scores were long term interval after treatment and sphincter-saving surgery. In addition, surgery type and follow-up time were determined to be predictors of QOL scores and late toxicity grade. Conclusion: Postoperative CRT was found to have a great impact on the long term QOL and side effects in rectal cancer survivors. The factors that adversely affect these are abdominoperineal resection and shorter interval. The findings may encourage life-long follow-up and cooperation with patients, which should be mentioned during the initial counseling.

The role of plasma cell-free DNA detection in predicting preoperative chemoradiotherapy response in rectal cancer patients

“…Preoperative chemoradiotherapy is now considered as standard treatment for patients with locally advanced rectal cancer (22). Preoperative radiochemotherapy was shown to improve local disease control and even longterm survival (23). It was also beneficial in reducing tumor spread, increasing pathological complete response rates and improving sphincter preservation after surgery (24).…”

Candidate Predictors of Health-Related Quality of Life of Colorectal Cancer Survivors: A Systematic Review

“…Contrasting results were found regarding the association of different types of surgery with HRQoL in rectal cancer survivors [76,77]. Additionally, studies in CRC survivors observed either no significant association of treatment-related variables with HRQoL [34,36,39,42] or that not having received adjuvant therapy besides surgery was associated with lower HRQoL [35,43].…”

“…Quality of Life Predictors in Colorectal Cancer point during the study (i.e., baseline) was associated with lower HRQoL reported at later time points during study followup from 6 weeks post-treatment up to 5 years postdiagnosis [29,31,33,35,54,65,69,75]. Furthermore, six studies (one longitudinal) showed that shorter time since diagnosis was associated with lower HRQoL reported by CRC survivors [39,43,[48][49][50]77]. Finally, poorer self-reported general health was observed to be associated with lower HRQoL of CRC survivors [69].…”

Psychometric Validation of the Malaysian Chinese Version of the EORTC QLQ-C30 in Colorectal Cancer Patients

“…Numerous researchers indicate that patients with colorectal cancer disease experience impairment in their Health-related Quality of Life (HRQOL) (Gujral et al, 2008;Kilic et al, 2012;Abu-Helalah et al, 2014). The HRQOL research in patients with cancer underwent several developments over the last three decades with European Organization for Research and Treatment of Cancer (EORTC) playing a major role (Velikova et al, 2012).…”