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The time course of health-related Quality of Life in rectal cancer patients undergoing combined modality treatment. | LitMetric
Background And Purpose : This exploratory prospective observational study investigated the changes in Health-related Quality of Life (HRQoL) in rectal cancer patients (RCPs), from diagnosis to one-year-post-surgery follow-up and explored the role of physical symptoms and psychological determinants on HRQoL at the different time points.Materials And Methods : We assessed HRQoL, psychological distress, coping, affectivity, alexithymia and social support in 43 RCPs treated with preoperative (chemo)radiation and surgery, at three different assessment time points: diagnosis (T0), one month after the end of preoperative treatment (T1), one month after resection surgery (T2), and at follow-up (T3).Results : The data showed that HRQoL decreased during active treatments, especially between T1 and T2 ( = 0.005), before increasing again at follow-up ( = 0.002).Baseline intestinal symptoms ( < 0.001) and negative affectivity trait ( = 0.03) significantly predicted HRQoL at T0. Baseline pain ( < 0.001), intestinal ( = 0.003) and urinary ( = 0.009) symptoms at T1 significantly predicted HRQoL at T1. A fatalistic coping style at T1 ( = 0.013), psychological distress ( = 0.003), mouth symptoms ( = 0.001) at T2 significantly predicted HRQoL at T2. Similarly, a fatalistic coping style at T1 ( = 0.006), psychological distress ( = 0.004), mouth ( = 0.002) and pain symptoms ( = 0.002) at T3 significantly predicted HRQoL at T3.Conclusion : Several physical and psychological factors are involved in the changes occurring after diagnosis in RCPs' HRQoL. While cancer-related symptoms and treatment-related physical side effects are the main predictors of HRQoL at diagnosis and during active treatments, early psychological reactions have a higher predictive weight in post-treatment HRQoL.These data emphasise the importance of active screening, early diagnosis, and preventive psychological interventions immediately after diagnosis to improve HRQoL and psychological health outcomes.
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