Combination chemoradiotherapy with or without surgery are internationally applied alternative strategies for potential cure of esophageal cancer.
Dr George Eid and colleagues from Pennsylvania compared health-related quality of life between patients selected for chemoradiation and those who had combination treatment including esophagectomy.
|Surgery was associated with a greater reduction in health-related quality of life|
|The British Journal of Surgery|
Patients with stage II or III esophageal cancer completed health-related quality of life assessments at baseline, at the worst expected time point and at expected recovery.
Health-related quality of life was compared between groups using linear regression, adjusting for age, sex, performance status, tumour stage and type, and baseline health-related quality of life.
The researcher assessed 132 patients who began treatment, of whom 51 had chemoradiotherapy and 81 combination treatment including surgery.
Patients selected for chemoradiotherapy were older.
The team also found that patients selected for chemoradiotherapy were more likely to have squamous cell cancer.
These patients reported poorer health-related quality of life than those selected for surgery.
The team found at the worst expected time point after treatment, both groups reported multiple symptoms and poor function.
However, surgery was associated with a greater reduction in health-related quality of life from baseline than chemoradiotherapy.
Recovery of health-related quality of life was achieved within 6 months after chemoradiotherapy.
Complete recovery had not occurred 6 months after surgery and there was persistent significant deterioration in some aspects.
Dr Eid's team concluded, "The negative treatment-related impact of chemoradiation on short-term health-related quality of life is less than that experienced with combination treatment including surgery."
"Patients preferring early recovery should consider definitive chemoradiation."