Objective To explore the quality of life of colorectal cancer patients undergoing multi-disciplinary comprehensive treatment by neo-adjuvant chemotherapy combined with radical resection. Methods From May 2007 to August 2007, the patients diagnosed definitely as colorectal cancer were analyzed retrospectively, of whom accepted neo-adjuvant chemotherapy combined with surgery were included and evaluated by quality of life questionnaire-core 30 (QLQ-C30) of European Organization for Research and Treatment of Cancer (EORTC), and there were 3 time points chosen for assessment which were pre-neoadjuvant chemotherapy stage (point A), preoperative stage after neo-adjuvant chemotherapy (point B), and one month after surgery (point C). Results A total of 57 patients with an average age of 56.33 years (41-69 years) were incorporated in this study, and among which there were 34 male and 23 female; and 10 right-sided hemi-colonic cancer, 4 left sided hemi-colonic cancer, 43 rectal cancer. The global health differences between the A and B point or A and C point were statistically significant (P lt;0.001) whereas no significant difference existed between B and C point (P gt;0.05). For the functioning scales of physical, physical, role, cognitive, and social function, no statistically difference among A, B and C time point. Although there wasn’t any emotional difference existed between A and B point (P gt;0.05), obvious differ between C and A or C and B point were showed out (P lt;0.005). And for symptom scales, no remarkable differences came out among A, B and C point for dyspnoea and constipation (P gt;0.05); reversely, great differences were found for fatigue, pain, insomnia, appetite loss, and diarrhoea between C and A or C and B point (P lt;0.01), but nope for A and B in the 5 items of symptom (P gt;0.05). And the score of nausea and vomiting presented significantly differences between A and B or B and C point (P lt;0.01), but nope for A and C in this item (P gt;0.05). There came out distinct significantly for financial impact among A, B and C point with a worsen score from early to late stage (P lt;0.001). Conclusion The intervention of chemotherapy could worsen the quality of life during the treatment of neo-adjuvant chemotherapy combined with surgery which may be attributed to the side reaction, but such adverse reaction may not affect actually the postoperative subjective feeling; On the other hand, the colorectal surgery may not decrease the quality of life although which could lead more early postoperative uncomforting. However, it needs more researches to discuss about the contribution of different comprehensive treatment strategy to the quality of life as well as the cost-effective analysis.
Citation:
WANG Xiaodong,LIU Chunjuan,CHEN Zengrong,QIU Meng,LI Li.. Quality of Life in Colorectal Cancer Patients with Neo-Adjuvant Chemotherapy Combined with Radical Resection in Multi-Disciplinary Team. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(5): 371-374. doi:
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- 1. 汪晓东, 李亚伦, 邱萌, 等. 多学科协作诊治模式下新辅助化疗对直肠癌手术的影响 [J]. 中国普外基础与临床杂志, 2008; 15(2)∶136.
- 2. Scarpa M, Erroi F, Ruffolo C, et al. Minimally invasive surgery for colorectal cancer: quality of life, body image, cosmesis, and functional results [J]. Surg Endosc, 2008; Apr, 4 \[Epub ahead of print\].
- 3. Miguel RS, López-González AM, Sanchez-Iriso E, et al. Measuring health-related quality of life in drug clinical trials: is it given due importance? [J] Pharm World Sci, 2008; 30(2)∶154.
- 4. 汪晓东, 邱萌, 李亚伦, 等. 多学科协作诊治模式下结直肠癌不同周期新辅助化疗联合手术的方案研究 [J]. 中国普外基础与临床杂志, 2008; 15(3)∶210.
- 5. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology [J]. J Natl Cancer Inst, 1993; 85(5)∶365.
- 6. Zhao H, Kanda K. Testing psychometric properties of the standard Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30) [J]. J Epidemiol, 2004; 14(6)∶193.
- 7. 汪晓东, 冯硕, 游小林, 等. 结直肠肿瘤多学科协作诊治模式下的随访体系建设 [J]. 中国普外基础与临床杂志, 2007; 14(6)∶709.
- 8. Schwenk W, Neudecker J, Haase O, et al. Comparison of EORTC quality of life core questionnaire (EORTC-QLQ-C30) and gastrointestinal quality of life index (GIQLI) in patients undergoing elective colorectal cancer resection [J]. Int J Colorectal Dis, 2004; 19(6)∶554.
- 9. Rotonda C, Conroy T, Mercier M, et al. Validation of the French version of the colorectal-specific quality-of-life questionnaires EORTC QLQ-CR38 and FACT-C [J]. Qual Life Res, 2008; 17(3)∶437.
- 10. Hassan I, Cima RR. Quality of life after rectal resection and multimodality therapy [J]. J Surg Oncol, 2007; 96(8)∶684.
- 11. Luppi G, Santantonio M, Bertolini F, et al. Preoperative concomitant radiotherapy and chemotherapy in ultrasound-staged T3 and T4 rectal cancer [J]. Tumori, 2003; 89(2)∶152.