Abstract
Background
Adjuvant chemotherapy of oral uracil/ftorafur (UFT) plus leucovorin (LV) has been accepted as the standard of care in the treatment of patients with stage II and III carcinoma of the colon. The objective of the study was to compare HRQOL reported by patients receiving oral UFT plus LV (UFT/LV group) versus no adjuvant treatment (control group) following surgery for colorectal cancer.
Methods
Ninety nine patients in the UFT/LV group and 83 in the control group participated. HRQOL was assessed with the European Organization for Research and Treatment of Cancer QLQ-C30 and HRQOL data measured longitudinally following surgery were compared between the groups.
Results
Eighty-eight percent (87 of 99) received all scheduled doses of UFT plus LV during the first three cycles, and 82 percent (81 of 99) did so for five cycles. The most common type of toxicity in the UFT/LV group was fatigue, which was generally mild. Six patients each had grade 3 diarrhea or anorexia. There were significant differences in the scores for role function, and specific limitations such as fatigue, nausea, and vomiting, dyspnoea, appetite loss, and financial difficulties, which deteriorated in the UFT/LV group.
Conclusions
HRQOL in colorectal cancer patients with adjuvant chemotherapy with oral UFT plus LV deteriorated during this phase of treatment compared with those with surgery alone, despite the biased stage of tumor between the groups. Symptom management and social support would improve HRQOL in such a group of patients.
Similar content being viewed by others
References
Lembersky BC, Wieand HS, Petrelli NJ et al (2006) Oral uracil and tegafur plus leucovorin compared with intravenous fluorouracil and leucovorin in stage II and III carcinoma of the colon: results from National Surgical Adjuvant Breast and Bowel Project C-06. J Clin Oncol 24:2059–2064
Kopec JA, Yothers G, Ganz PA et al (2007) Quality of life in operable colon cancer patients receiving oral compared with intravenous chemotherapy: results from National Surgical Adjuvant Breast and Bowel Project C-06. J Clin Oncol 25:424–430
Tsunoda A, Nakao K, Hiratsuka K et al (2007) Prospective analysis of quality of life in the first year after colorectal cancer surgery. Acta Oncol 46:77–82
Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376
Kobayashi K, Takeda F, Teramukai S et al (1998) A cross-validation of the European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30) for Japanese with lung cancer. Eur J Cancer 34:810–815
EOETC Study Group on Quality of Life (1995) EORTC QLQ-C30 scoring manual. EORTC, Brussels
Osoba D, Rodrigues G, Myles J et al (1998) Interpreting the significance of changes in health-related quality-of-life-scores. J Clin Oncol 16:139–144
Ramsey SD, Andersen MR, Etzioni R et al (2000) Quality of life in survivors of colorectal carcinoma. Cancer 88:1294–1303
Tsunoda A, Yasuda N, Nakao K et al (2008) Validation of the Japanese version of EORTC QLQ-CR38. Qual Life Res 17:317–322
Zaniboni A, Labianca R, Marsoni S et al (1998) A randomized trial of adjuvant 5-fluorouracil and folic acid administered to patients with colon carcinoma—long term results and evaluation of the indicators of health-related quality of life. Cancer 82:2135–2144
Douillard JY, Hoff PM, Skillings JR et al (2002) Multicenter phase III study of uracil/tegafur and oral leucovorin versus fluorouracil and leucovorin in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 20:3605–3616
Carmichael JC, Popiela T, Radstone D et al (2002) Randomized comparative study of tegafur/uracil and oral leucovorin versus parenteral fluorouracil and leucovorin in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 20:3617–3627
Shirao K, Hoff PM, Ohtsu A et al (2004) Comparison of the efficacy, toxicity, and pharmacokinetics of a uracil/tegafur (UFT) plus oral leucovorin (LV) regimen between Japanese and American patients with advanced colorectal cancer: Joint United States and Japan Study of UFT/LV. J Clin Oncol 22:3466–3474
Sugihara K, Kobayashi H, Kato T et al (2006) Indication and benefit of pelvic sidewall dissection for rectal cancer. Dis Colon Rectum 49:1663–1672
Sakamoto J, Hamada C, Yoshida S et al (2007) An individual patient data meta-analysis of adjuvant therapy with uracil-tegafur (UFT) in patients with curatively resected rectal cancer. Br J Cancer 96:1170–1177
Sprangers MAG, Taal BG, Aaronson NK et al (2005) Quality of life in colorectal cancer—stoma vs. nonstoma patients. Dis Colon Rectum 38:361–369
Conflict of interest statement
No author has any conflict of interest.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Tsunoda, A., Nakao, K., Tsunoda, Y. et al. Health-related quality of life of colorectal cancer patients receiving oral UFT plus leucovorin compared with those with surgery alone. Int J Clin Oncol 15, 153–160 (2010). https://doi.org/10.1007/s10147-010-0035-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10147-010-0035-z