Quality-of-life measurements in patients receiving radiation therapy for colorectal malignancies as compared to other gastrointestinal malignancies.

Abstract

587 Background: Therapy for GI malignancies has long been known to have a marked impact on quality of life, yet this relationship remains poorly understood. Methods: A retrospective, IRB-approved chart review was performed of 722 patients receiving RT for any cancer diagnosis between 1/1/2006 and 12/31/2008. Subjects completed the Functional Assessment of Cancer Therapy General (FACT-G) questionnaire before and after RT. Pre- and immediately post-RT course scores were compared using student t-tests with Bonferroni correction for multiple comparisons (5 comparisons, alpha =.01). Results: 722 of 1369 (52.7%) possible patients participated in the database. Complete pre and post RT spirituality data were available for 73 (64.6%) patients with GI malignancies. Average age was 62 years, 58 (79%) were male and 52 (71%) received definitive treatment. 27 (37%) had esophageal or gastric cancer, 22 (30%) had colorectal cancer and 24 (33%) had other GI malignancies such as pancreatic or hepatobiliary. Colorectal cancer patients fared better in overall QOL as compared to esophageal and gastric patients, pancreatic and hepatobiliary patients and patients with GI malignancies as a whole, and were the only group in which decline in overall QOL as measured by the FACT-G (77.22 to 73.08, p=0.216) did not reach or approach significance. This appeared to be largely driven by differences in physical and especially functional well-being, in which colorectal patients demonstrated the smallest decline (16.14 to 15.59, p=0.466) of any group. Colorectal patients did, however, demonstrate a larger decline in physical well-being (22.35 to 18.05, p=0.010) and overall QOL than did all-comers with any primary malignancy (22.1 to 19.4, p<.001) and (81.3 to 78.9, p<.001) respectively. Conclusions: Physical and functional well-being, as well as overall quality of life are known to decline in patients with GI malignancies. Patients with colorectal disease appear to fare better than those with esophageal, stomach, pancreatic or hepatobiliary malignancies by these measures. Additional investigations are warranted to further define these differences. No significant financial relationships to disclose.