Long-term quality of life after treatment for locally advanced oropharyngeal carcinoma: Surgery and postoperative radiotherapy versus concurrent chemoradiation

Oral Oncology ◽  
2009 ◽  
Vol 45 (11) ◽  
pp. 953-957 ◽  
Author(s):  
Paolo Boscolo-Rizzo ◽  
Marco Stellin ◽  
Roberto Fuson ◽  
Carlo Marchiori ◽  
Alessandro Gava ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Radiotherapy ◽  
Locally Advanced ◽  
Concurrent Chemoradiation ◽  
Oropharyngeal Carcinoma

Long-term consequences of exenterative surgery for people with pelvic cancer.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 118-118 ◽  
Author(s):  
Jane Young ◽  
Michael Solomon ◽  
Daniel Steffens ◽  
Cherry Koh
Keyword(s):  
Quality Of Life ◽  
Locally Advanced ◽  
Resection Margins ◽  
R0 Resection ◽  
Personal Goals ◽  
Pelvic Cancer ◽  
Patient Reported ◽  
Ongoing Pain

118 Background: For people with recurrent or locally advanced pelvic cancer with no evidence of metastatic spread, pelvic exenteration (PE) surgery that achieves clear (R0) resection margins is the only potentially curative treatment option. This extensive, radical surgery can involve removal of the pelvic organs, muscles, nerves and bone, resulting in significant impairment for patients. The aim of this study is to describe the long-term quality of life outcomes for this procedure, specifically to investigate levels of pain, vitality, depression and ability to achieve personal goals among survivors three or more years after surgery. Methods: The Royal Prince Alfred Hospital in Sydney is a national referral center for PE in Australia. Patient-reported outcome measures, including generic (SF36) and colorectal cancer-specific (FACT-C) measures of quality of life (QoL), pain, vitality, depression and self-reported ability to achieve personal goals are assessed pre-surgery, every six months to three years and then annually. Consecutive patients who were three or more years after PE comprised the sample for this study. Trajectories for patient reported outcomes were plotted and the proportion of survivors who experienced ongoing pain, vitality and depression at each time point were calculated. Results: Among 241 patients who were 3 years post-PE, 63 (26%, 95% CI: 21-32%) had died and 3-year QoL assessments were completed by 65 (51%) of survivors. Three years after surgery, mean QoL scores were similar to baseline and remained fairly stable among survivors to 5 years. There was a small decrease over time in the proportion of survivors reporting ongoing pain. From 3 years onwards, approximately 70% (95% CI: 58-79%) of survivors reported ongoing pain and 44% (95% CI: 34-57%) reported some level of depression. However, SF-36 vitality scores increased slightly from a mean of 46.2 pre-PE to 54.0 at 3 years. Conclusions: Despite the extensive nature of PE surgery, the majority of survivors achieved reasonable long-term quality of life. However, high levels of chronic pain and depression indicate ongoing needs for supportive care in this patient group.

scholarly journals Quality of Life Supersedes the Classic Prognosticators for Long-Term Survival in Locally Advanced Non–Small-Cell Lung Cancer: An Analysis of RTOG 9801

2009 ◽  
Vol 27 (34) ◽  
pp. 5816-5822 ◽  
Author(s):  
Benjamin Movsas ◽  
Jennifer Moughan ◽  
Linda Sarna ◽  
Corey Langer ◽  
Maria Werner-Wasik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung

Purpose To determine the added value of quality of life (QOL) as a prognostic factor for overall survival (OS) in patients with locally advanced non–small-cell lung cancer (NSCLC) treated on Radiation Therapy Oncology Group RTOG-9801. Patients and Methods Two hundred forty-three patients with stage II/IIIAB NSCLC received induction paclitaxel and carboplatin (PC) and then concurrent weekly PC and hyperfractionated radiation (to 69.6 Gy). Patients were randomly assigned to amifostine (AM) or no AM during chemoradiotherapy. The following pretreatment factors were analyzed as prognostic factors for OS: Karnofsky performance status, stage, sex, age, race, marital status, histology, tumor location, hemoglobin, tobacco use, treatment arm (AM v no AM) and QOL scores (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 [QLQ-C30] and Lung Cancer 13 [LC-13]). A multivariate (MVA) Cox proportional hazards model was performed using a backwards selection process. Results Of the 239 analyzable patients, 91% had a baseline global QOL score. Median follow-up time was 59 months for patients still alive and 17 months for all patients. Median baseline QLQ-C30 global QOL score was 66.7 on both treatment arms. Whether the global QOL score was treated as a dichotomized variable (based on the median score) or a continuous variable, all other variables fell out of the MVA for OS. Patients with a global QOL score less than 66.7 had an approximately 70% higher rate of death than patients with scores ≥ 66.7 (P = .004). A 10-point higher baseline global QOL score corresponded to a decrease in the hazard of death by approximately 10% (P = .004). The other independent QOL predictors for OS were the QLQ-C30 physical functioning (P = .011) and LC-13 dyspnea scores (P = .012). Conclusion In this analysis, baseline global QOL score replaced known prognostic factors as the sole predictor of long-term OS for patients with locally advanced NSCLC.

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