ADJUVANT CHEMOTHERAPY FOR COLORECTAL-CANCER - EVALUATION OF THE QUALITY-OF-LIFE

Enhanced 5 year survival rates with adjuvant chemotherapy for colon an d rectal cancers are 5% and 9% respectively, according to recent meta- analysis. Despite the NM consensus statement endorsing adjuvant chemot herapy, many clinicians regard such a seemingly small benefit not just worthy of the expense, inconvenience, discomfort and risk of treatment for their individual patient with colorectal carcinoma. The aim of th is study is to evaluate these quality of life issues. The seven criter ia considered most important were determined by interviews of treated patients, who emphasized the following quality of life parameters: nau sea and vomiting, diarrhea, perineal dermatitis, asthenia, impairment of daily activity, family support, and difficulties of daily transport ation to hospital. A numeric scale (1-5) was used to measure their ans wers (0 = hospitalization, 5 = no modification), and the nonparametric rank coefficient of Kendall was used to compare them. Twenty patients with colon cancer treated with Moertel's protocol and 5 patients with rectal cancer treated with Krook's protocol were evaluated. The study revealed a diminished quality of life for both patients with colon ca ncer (7 on a scale of 10) and those with rectal cancer (6 on the same scale). By using the same questionnaire at one week interval, the resp onses remained unchanged (p < 0.001). The effect of radiotherapy seems to be responsible for this difference. This study is one of the first to approach the quality of life from the real interested party's poin t of view : the patient.