gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Age-specific administration of chemotherapy and long-term quality of life in stage II and III colorectal cancer patients – a population-based prospective cohort

Meeting Abstract

  • Lina Jansen - Deutsches Krebsforschungszentrum (DKFZ), Abteilung Klinische Epidemiologie und Alternsforschung, Heidelberg
  • Michael Hoffmeister - Deutsches Krebsforschungszentrum (DKFZ), Abteilung Klinische Epidemiologie und Alternsforschung, Heidelberg
  • Jenny Chang-Claude - Deutsches Krebsforschungszentrum (DKFZ), Abteilung Epidemiologie von Krebserkrankungen, Heidelberg
  • Moritz Koch - Universität Heidelberg, Abteilung für Allgemein, Viszeral- und Transplantationschirurgie, Heidelberg
  • Hermann Brenner - Deutsches Krebsforschungszentrum (DKFZ), Abteilung Klinische Epidemiologie und Alternsforschung, Heidelberg
  • Volker Arndt - Deutsches Krebsforschungszentrum (DKFZ), Abteilung Klinische Epidemiologie und Alternsforschung, Heidelberg

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds211

DOI: 10.3205/11gmds211, URN: urn:nbn:de:0183-11gmds2111

Published: September 20, 2011

© 2011 Jansen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction: Addressing therapy-related long-terms effects in cancer patients becomes increasingly important but pertinent knowledge is scant. Therefore, we investigated the age-specific pattern of administration of chemotherapy and its association with long-term survival and quality of life (QoL) in stage II and III colorectal cancer.

Material and Methods: The administration of chemotherapy was investigated according to disease and patient characteristics in a population-based cohort of 562 patients from the Rhine-Neckar-Odenwald region with a diagnosis of stage II or III colorectal cancer in 2003 or 2004 (DACHS study). Five years after diagnosis, survival was determined and QoL was assessed in survivors using the cancer-specific quality of life questionnaire of the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) and the supplementary colorectal cancer specific module QLQ-CR29. The association between chemotherapy and QoL was examined with analysis of covariance to control for potential confounders.

Results: Chemotherapy was administered in 71% of patients younger than 60 years at diagnosis and in only 20% of patients aged 80 years and older. Chemotherapy was significantly associated with longer survival time in stage III cancer only. No association was found between chemotherapy and QoL functioning scores, but survivors who received chemotherapy reported higher symptom levels for trouble with taste, anxiety, and hair loss even five years after diagnosis. In age-specific analyses, younger survivors (< 70 years at time of follow-up) with a history of chemotherapy reported significantly lower physical, role, and cognitive functioning, and elevated pain, appetite loss, hair loss, and trouble with taste symptom levels than survivors who did not receive chemotherapy. In contrast, no significant association was found between chemotherapy and QoL scores for older survivors (≥ 70 years) except hair loss and dry mouth.

Discussion / Conclusion: Especially in younger survivors chemotherapy is associated with lower QoL even five years after diagnosis. In case of uncertain survival benefits of chemotherapy, such potential detrimental effects should be incorporated for a final decision on treatment. In addition, clinicians should inform the patients about potential consequences of treatment.

Funding: This study was funded by the IMPACT project (Improving long-term prognosis and quality of life of patients with colorectal cancer), a project within the funding program on 'Long-term investigations in health research' of the German Federal Ministry of Education and Research (grant no. 01 ER 0814).