Effect of Neoadjuvant Chemoradiotherapy on Health-Related Quality of Life in Esophageal or Junctional Cancer: Results From the Randomized CROSS Trial
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Published:2018-01-20
Issue:3
Volume:36
Page:268-275
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ISSN:0732-183X
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Container-title:Journal of Clinical Oncology
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language:en
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Short-container-title:JCO
Author:
Noordman Bo Jan1, Verdam Mathilde G.E.1, Lagarde Sjoerd M.1, Hulshof Maarten C.C.M.1, van Hagen Pieter1, van Berge Henegouwen Mark I.1, Wijnhoven Bas P.L.1, van Laarhoven Hanneke W.M.1, Nieuwenhuijzen Grard A.P.1, Hospers Geke A.P.1, Bonenkamp Johannes J.1, Cuesta Miguel A.1, Blaisse Reinoud J.B.1, Busch Olivier R.1, ten Kate Fiebo J.W.1, Creemers Geert-Jan M.1, Punt Cornelis J.A.1, Plukker John Th.M.1, Verheul Henk M.W.1, Spillenaar Bilgen Ernst J.1, van Dekken Herman1, van der Sangen Maurice J.C.1, Rozema Tom1, Biermann Katharina1, Beukema Jannet C.1, Piet Anna H.M.1, van Rij Caroline M.1, Reinders Janny G.1, Tilanus Hugo W.1, Steyerberg Ewout W.1, van der Gaast Ate1, Sprangers Mirjam A.G.1, van Lanschot J. Jan B.1
Affiliation:
1. Bo Jan Noordman, Sjoerd M. Lagarde, Pieter van Hagen, Bas P.L. Wijnhoven, Fiebo J.W. ten Kate, Katharina Biermann, Caroline M. van Rij, Hugo W. Tilanus, Ewout W. Steyerberg, Ate van der Gaast, and J. Jan B. van Lanschot, Erasmus MC–University Medical Center Rotterdam; Mathilde G.E. Verdam, Maarten C.C.M. Hulshof, Mark I. van Berge Henegouwen, Hanneke W.M. van Laarhoven, Olivier R. Busch, Fiebo J.W. ten Kate, Cornelis J.A. Punt, and Mirjam A.G. Sprangers, Academic Medical Center; Miguel A. Cuesta, Henk M...
Abstract
Purpose To compare pre-agreed health-related quality of life (HRQOL) domains in patients with esophageal or junctional cancer who received neoadjuvant chemoradiotherapy (nCRT) followed by surgery or surgery alone. Secondary aims were to examine the effect of nCRT on HRQOL before surgery and the effect of surgery on HRQOL. Patients and Methods Patients were randomly assigned to nCRT (carboplatin plus paclitaxel with concurrent 41.4-Gy radiotherapy) followed by surgery or surgery alone. HRQOL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 (QLQ-C30) and –Oesophageal Cancer Module (QLQ-OES24) questionnaires pretreatment and at 3, 6, 9, and 12 months postoperatively. The nCRT group also received preoperative questionnaires. Physical functioning (PF; QLQ-C30) and eating problems (EA; QLQ-OES24) were chosen as predefined primary end points. Predefined secondary end points were global QOL (GQOL; QLQ-C30), fatigue (FA; QLQ-C30), and emotional problems (EM; QLQ-OES24). Results A total of 363 patients were analyzed. No statistically significant differences in postoperative HRQOL were found between treatment groups. In the nCRT group, PF, EA, GQOL, FA, and EM scores deteriorated 1 week after nCRT (Cohen’s d: −0.93, P < .001; 0.47, P < .001; −0.84, P < .001; 1.45, P < .001; and 0.32, P = .001, respectively). In both treatment groups, all end points declined 3 months postoperatively compared with baseline (Cohen’s d: −1.00, 0.33, −0.47, −0.34, and 0.33, respectively; all P < .001), followed by a continuous gradual improvement. EA, GQOL, and EM were restored to baseline levels during follow-up, whereas PF and FA remained impaired 1 year postoperatively (Cohen’s d: 0.52 and −0.53, respectively; both P < .001). Conclusion Although HRQOL declined during nCRT, no effect of nCRT was apparent on postoperative HRQOL compared with surgery alone. In addition to the improvement in survival, these findings support the view that nCRT according to the Chemoradiotherapy for Esophageal Cancer Followed by Surgery Study–regimen can be regarded as a standard of care.
Publisher
American Society of Clinical Oncology (ASCO)
Subject
Cancer Research,Oncology
Cited by
92 articles.
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