Patient and Clinical Variables Account for Changes in HealthrelatedQuality of Life and Symptom Burden as TreatmentOutcomes in Colorectal Cancer: A Longitudinal Study


Objective: The aim of the current study was to evaluate changes in treatment outcomes in terms of healthrelatedquality of life (HRQoL) and symptom burden at zero, one, three, and six months after an initial diagnosisof colorectal cancer. The demographic and clinical characteristics that account for outcome changes in patientswere investigated using a repeated measures framework. Methods and Materials: A cohort study was performedof 134 colorectal cancer patients followed from diagnosis to 6 months post-treatment in Central Taiwan. HRQoLand symptoms were assessed at diagnosis and one, three, and six months thereafter. The Functional Assessmentof Cancer Therapy-Colon (FACT-C) questionnaire, VAS pain, and the Memorial Symptom Assessment Scale(MSAS) were used for data collection. A generalized estimating equation (GEE) was applied for statisticalanalysis.
Results: The majority of the patients were male (55%) and married (91.5%). The mean age was 60.4years (SD = 11.71). Most were diagnosed stage III and IV colorectal cancer (54.5%). All underwent surgery;some also received chemotherapy (CT) or concurrent chemoradiation therapy (CCRT). The results of the GEEshowed that overall, the HRQoL, pain, and symptoms of the patients significantly improved over the treatmentperiod. Patients with stage IV disease who had received surgery and CCRT showed the worst HRQoL. Females,patients with comorbidity, and stage IV patients had higher pain scores over time. Female and stage IV patientshad more severe physical symptoms, whereas stage II and IV patients had worse psychological symptoms overtime.
Conclusion: The patients’ HRQoL, pain, and symptoms significantly improved over the 6-month treatmentperiod. Certain patient and clinical variables accounted for changes in treatment outcomes regarding HRQoLand symptom burden in colorectal cancer patients.