‘Debulking’ does not negatively impact quality of life in patients with colorectal cancer
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Key takeaways:
- No statistically significant differences in health-related quality of life occurred with debulking plus systemic therapy.
- Significant adverse events occurred among twice as many patients assigned a debulking regimen.
Debulking combined with standard systemic therapy did not significantly impact overall quality of life for a cohort of patients with metastatic colorectal cancer, according to study results.
The findings — published in Journal of the National Comprehensive Cancer Network — also showed that patients assigned the debulking intervention experienced twofold higher serious adverse events compared with patients in the standard treatment group, researchers concluded.
Rationale and methodology
“Maintaining a sufficient health-related quality of life is important in the palliative treatment of patients with metastatic colorectal cancer,” Lotte Bakkerus, MD, researcher in the department of medical oncology at Radboud Institute for Health Sciences, the Netherlands, and colleagues wrote.
Researchers sought to prospectively evaluate OS benefit and impact on health-related quality of life among 300 patients with multiorgan metastatic colorectal cancer randomly assigned to either tumor debulking plus first-line palliative systemic therapy (n = 148) or standard systemic therapy alone (n = 152).
Findings
Results showed no statistically significant differences in health-related quality of life or fatigue among patients assigned the debulking plus systemic therapy regimen vs. standard systemic therapy alone.
Researchers further observed no significant differences in health-related quality of life after 1 year of treatment in both treatment groups.
However, results showed a twofold higher serious adverse event rate among patients assigned debulking plus systemic therapy (P ≤ .001). Researchers observed significant adverse events among 43% of patients assigned the debulking regimen vs. 21% of patients assigned standard systemic therapy.
“This could mean that the negative impact of complications on quality of life is temporary and eventually balances out with a decrease in tumor-related symptoms after treatment,” Bakkerus said in a press release. “Patients might also adapt their health-related quality of life perceptions during the course of their disease and treatment.”
Future research
“Given the considerable amount of complications from local treatment, we had expected to see a bigger impact on overall and persistent quality of life in the experimental group,” Bakkerus said in the release. “The fact that local therapy associated serious side effects did not translate to a noticeable dip in the patients’ perceived quality of life is quite intriguing and warrants further exploration. These results, including the risk [for] complications, should be taken into account in the consultation room in order to decide, together with the patient, what the right treatment choice is for each individual.”
References:
- Bakkerus L, et al. J Natl Compr Canc Netw. 2023;doi:10.6004/jnccn.2023.7050.
- More aggressive treatment doesn’t impact quality of life for metastatic colorectal cancer patients, according to new study in JNCCN (press release). Available at: https://www.nccn.org/home/news/newsdetails?NewsId=4186. Published Oct. 12, 2023. Accessed Oct. 16, 2023.
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