Quality of Life in Vulnerable Older Patients with Metastatic Colorectal Cancer Receiving Palliative Chemotherapy-The Randomized NORDIC9-Study

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dc.contributor.author Liposits, G
dc.contributor.author Eshoj, HR
dc.contributor.author Moller, S
dc.contributor.author Winther, SB
dc.contributor.author Skuladottir, H
dc.contributor.author Ryg, J
dc.contributor.author Hofsli, E
dc.contributor.author Shah, CH
dc.contributor.author Poulsen, LO
dc.contributor.author Berglund, A
dc.contributor.author Qvortrup, C
dc.contributor.author Osterlund, P
dc.contributor.author Glimelius, B
dc.contributor.author Sorbye, H
dc.contributor.author Pfeiffer, P
dc.date.accessioned 2021-10-25T11:10:02Z
dc.date.available 2021-10-25T11:10:02Z
dc.date.issued 2021-06
dc.identifier.citation Liposits , G , Eshoj , HR , Moller , S , Winther , SB , Skuladottir , H , Ryg , J , Hofsli , E , Shah , CH , Poulsen , LO , Berglund , A , Qvortrup , C , Osterlund , P , Glimelius , B , Sorbye , H & Pfeiffer , P 2021 , ' Quality of Life in Vulnerable Older Patients with Metastatic Colorectal Cancer Receiving Palliative Chemotherapy-The Randomized NORDIC9-Study ' , Cancers , vol. 13 , no. 11 , 2604 . https://doi.org/10.3390/cancers13112604
dc.identifier.other PURE: 169765030
dc.identifier.other PURE UUID: b47ac785-81b9-4231-af51-eab25b1ffd74
dc.identifier.other RIS: urn:9E587F3AC97E0F0B7CB8EC73F93780B2
dc.identifier.other WOS: 000659614100001
dc.identifier.uri http://hdl.handle.net/10138/335640
dc.description.abstract Simple Summary Bowel cancer is one of the leading cancer-types in both sexes worldwide. Despite that most new cases and deaths occur in people aged 70 years or older, few clinical trials have investigated the best way to administer chemotherapy in older or frail patients. The NORDIC9-study established that moderately dose-reduced combination chemotherapy improved survival without extra side-effects compared to full dose single drug therapy. However, many older patients with incurable cancer seem to prefer preserved quality of life rather than longer survival. Therefore, our aim with the current quality of life analysis of the NORDIC9-study was to assess that the more effective chemotherapy was not at the expense of decreased quality of life. Our analyses showed that moderately dose-reduced combination chemotherapy-maintained quality of life, physical functioning, and resulted in less symptoms than treatment with full dose single drug in older patients not tolerating standard combination chemotherapy usually provided to young and fit patients. Quality of life data from randomized trials are lacking in older patients with metastatic colorectal cancer (mCRC). In the randomized NORDIC9-study, reduced-dose S1+oxaliplatin (SOx) showed superior efficacy compared to full-dose S1 monotherapy. We hypothesized that treatment with SOx does not result in inferior quality of life. Patients with mCRC aged >= 70 years and that were not a candidate for standard combination chemotherapy were included and randomly assigned to receive either S1 or SOx. The EORTC QLQ-C30 questionnaire was completed at baseline, after 9, and 18 weeks. The primary endpoint was global Quality of Life (QoL) at 9 weeks. For statistical analysis, a non-inferiority design was chosen applying linear mixed effects models for repeated measurements. The results were interpreted according to statistical significance and anchor-based, clinically relevant between-group minimally important differences (MID). A total of 160 patients aged (median (Interquartile range (IQR))) 78 years (76-81) were included. The QLQ-C30 questionnaire was completed by 150, 100, and 60 patients at baseline, at 9, and 18 weeks, respectively. The difference at 9 weeks in global QoL was 6.85 (95%CI-1.94; 15.65) and 7.37 (0.70; 14.05) in the physical functioning domain in favor of SOx exceeding the threshold for MID. At 18 weeks, the between-group MID in physical functioning was preserved. Dose-reduced combination chemotherapy may be recommended in vulnerable older patients with mCRC, rather than full-dose monotherapy. en
dc.format.extent 17
dc.language.iso eng
dc.relation.ispartof Cancers
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject older adults
dc.subject metastatic colorectal cancer
dc.subject chemotherapy
dc.subject vulnerability
dc.subject quality of life
dc.subject physical functioning
dc.subject EORTC QLQ-C30
dc.subject geriatric oncology
dc.subject GERIATRIC ASSESSMENT
dc.subject CLINICAL-TRIALS
dc.subject INTERNATIONAL SOCIETY
dc.subject EUROPEAN-ORGANIZATION
dc.subject AMERICAN SOCIETY
dc.subject ADULTS
dc.subject REPRESENTATION
dc.subject REGISTRATION
dc.subject MONOTHERAPY
dc.subject ENROLLMENT
dc.subject 3122 Cancers
dc.title Quality of Life in Vulnerable Older Patients with Metastatic Colorectal Cancer Receiving Palliative Chemotherapy-The Randomized NORDIC9-Study en
dc.type Article
dc.contributor.organization HUS Comprehensive Cancer Center
dc.contributor.organization Doctoral Programme in Biomedicine
dc.contributor.organization Department of Oncology
dc.contributor.organization Clinicum
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.3390/cancers13112604
dc.relation.issn 2072-6694
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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