TY - JOUR
T1 - Health-Related Quality of Life in Metastatic Colorectal Cancer Patients Treated with Curative Resection and/or Local Ablative Therapy or Systemic Therapy in the Finnish RAXO-Study
AU - Lehtomäki, Kaisa
AU - Stedt, Hanna P.
AU - Osterlund, Emerik
AU - Muhonen, Timo
AU - Soveri, Leena Maija
AU - Halonen, Päivi
AU - Salminen, Tapio K.
AU - Kononen, Juha
AU - Kallio, Raija
AU - Ålgars, Annika
AU - Heervä, Eetu
AU - Lamminmäki, Annamarja
AU - Uutela, Aki
AU - Nordin, Arno
AU - Lehto, Juho
AU - Saarto, Tiina
AU - Sintonen, Harri
AU - Kellokumpu-Lehtinen, Pirkko Liisa
AU - Ristamäki, Raija
AU - Glimelius, Bengt
AU - Isoniemi, Helena
AU - Osterlund, Pia
N1 - Funding Information:
Funding: This investigator-initiated study was supported by Finska Läkaresällskapet (2016, 2018, 2019, 2020, 2021, 2022), The Finnish Cancer Foundation (2019-2020, 2021, 2022-2023), the Competitive State Research Financing of the Expert Responsibility Area of Tampere, Helsinki, Turku, Kuopio, Oulu, and Satakunta Hospitals (2012, 2016, 2017, 2018, 2019, 2020, 2021, 2022), Tampere University Hospital Fund (Tukisäätiö 2019, 2020 and OOO-project 2020), Helsinki University Hospital research fund (2019, 2020, 2021, 2022), and the infrastructure with the database and study nurses partly supported by pharmaceutical companies (Amgen—unrestricted grant, Lilly, Merck KGaA, Roche Oy, Sanofi and Servier—unrestricted grant). The funders had no role in the study design, analysis, interpretation of the data or decision to publish.
Funding Information:
Conflicts of Interest: All authors report institutional research funding from Eli Lilly, Merck KGaA, Roche Finland, Sanofi and unrestricted grants from Amgen and Servier, during the conduct of the study. K.L., H.P.S., E.O., T.M., L.M.S.; P.H., T.K.S., J.K., R.K., A.Å., E.H., A.L.; A.U., A.N., R.R, B.G., H.I. and P.O. report grants, personal fees or non-financial support from Abbvie, Amgen, Astra-Zeneca, Baxalta/Shire, Bayer, BMS, Celgene, Eisai/Ewopharma, Eli Lilly, Erythech Pharma, Fresenius, Incyte, Jansen-Cilag, Medicom, Merck, MSD, Nordic Drugs/Pharma, Novartis, Nutricia/Danone, Pierre-Fabre, Roche, Sanofi, Servier, Sobi and/or Varian.
Funding Information:
This investigator-initiated study was supported by Finska L?kares?llskapet (2016, 2018, 2019, 2020, 2021, 2022), The Finnish Cancer Foundation (2019-2020, 2021, 2022-2023), the Competitive State Research Financing of the Expert Responsibility Area of Tampere, Helsinki, Turku, Kuopio, Oulu, and Satakunta Hospitals (2012, 2016, 2017, 2018, 2019, 2020, 2021, 2022), Tampere University Hospital Fund (Tukis??ti? 2019, 2020 and OOO-project 2020), Helsinki University Hospital research fund (2019, 2020, 2021, 2022), and the infrastructure with the database and study nurses partly supported by pharmaceutical companies (Amgen?unrestricted grant, Lilly, Merck KGaA, Roche Oy, Sanofi and Servier?unrestricted grant). The funders had no role in the study design, analysis, interpretation of the data or decision to publish.
Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/3
Y1 - 2022/3
N2 - Metastasectomy and/or local ablative therapy in metastatic colorectal cancer (mCRC) patients often provide long-term survival. Health-related quality of life (HRQoL) data in curatively treated mCRC are limited. In the RAXO-study that evaluated repeated resectability, a multi-crosssectional HRQoL substudy with 15D, EQ-5D-3L, QLQ-C30, and QLQ-CR29 questionnaires was conducted. Mean values of patients in different treatment groups were compared with age-and gender-standardized general Finnish populations. The questionnaire completion rate was 444/477 patients (93%, 1751 questionnaires). Mean HRQoL was 0.89–0.91 with the 15D, 0.85–0.87 with the EQ-5D, 68–80 with the EQ-5D-VAS, and 68–79 for global health status during curative treatment phases, with improvements in the remission phase (disease-free >18 months). In the remission phase, mean EQ-5D and 15D scores were similar to the general population. HRQoL remained stable during first-to later-line treatments, when the aim was no longer cure, and declined notably when tumourcontrolling therapy was no longer meaningful. The symptom burden affecting mCRC survivors’ well-being included insomnia, impotence, urinary frequency, and fatigue. Symptom burden was lower after treatment and slightly higher, though stable, through all phases of systemic therapy. HRQoL was high in curative treatment phases, further emphasizing the strategy of metastasectomy in mCRC when clinically meaningful.
AB - Metastasectomy and/or local ablative therapy in metastatic colorectal cancer (mCRC) patients often provide long-term survival. Health-related quality of life (HRQoL) data in curatively treated mCRC are limited. In the RAXO-study that evaluated repeated resectability, a multi-crosssectional HRQoL substudy with 15D, EQ-5D-3L, QLQ-C30, and QLQ-CR29 questionnaires was conducted. Mean values of patients in different treatment groups were compared with age-and gender-standardized general Finnish populations. The questionnaire completion rate was 444/477 patients (93%, 1751 questionnaires). Mean HRQoL was 0.89–0.91 with the 15D, 0.85–0.87 with the EQ-5D, 68–80 with the EQ-5D-VAS, and 68–79 for global health status during curative treatment phases, with improvements in the remission phase (disease-free >18 months). In the remission phase, mean EQ-5D and 15D scores were similar to the general population. HRQoL remained stable during first-to later-line treatments, when the aim was no longer cure, and declined notably when tumourcontrolling therapy was no longer meaningful. The symptom burden affecting mCRC survivors’ well-being included insomnia, impotence, urinary frequency, and fatigue. Symptom burden was lower after treatment and slightly higher, though stable, through all phases of systemic therapy. HRQoL was high in curative treatment phases, further emphasizing the strategy of metastasectomy in mCRC when clinically meaningful.
KW - 15D
KW - chemotherapy
KW - EQ-5D
KW - health-related quality of life
KW - local ablative therapy
KW - metastasectomy
KW - metastatic colorectal cancer
KW - QLQ-C30
KW - QLQ-CR29
KW - systemic therapy
U2 - 10.3390/cancers14071713
DO - 10.3390/cancers14071713
M3 - Article
AN - SCOPUS:85127041845
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 7
M1 - 1713
ER -