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Impact of individualized treatment on recovery from fatigue and return to work in survivors of advanced-stage Hodgkin's lymphoma: results from the randomized international GHSG HD18 trial
J. Ferdinandus, H. Müller, C. Damaschin, AS. Jacob, J. Meissner, F. Krasniqi, U. Mey, D. Schöndube, J. Thiemer, S. Mathas, J. Zijlstra, R. Greil, M. Feuring-Buske, J. Markova, JU. Rüffer, C. Kobe, HT. Eich, C. Baues, M. Fuchs, P. Borchmann, K. Behringer
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články
- MeSH
- Hodgkinova nemoc * patologie MeSH
- kvalita života MeSH
- lidé MeSH
- návrat do práce MeSH
- přežívající MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- únava etiologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Persisting cancer-related fatigue impairs health-related quality of life (HRQoL) and social reintegration in patients with Hodgkin's lymphoma (HL). The GHSG HD18 trial established treatment de-escalation for advanced-stage HL guided by positron emission tomography after two cycles (PET-2) as new standard. Here, we investigate the impact of treatment de-escalation on long-term HRQoL, time to recovery from fatigue (TTR-F), and time to return to work (TTR-W). PATIENTS AND METHODS: Patients received European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and life situation questionnaires at baseline, interim, end of treatment, and yearly follow-up. TTR-F was defined as time from the end of chemotherapy until the first fatigue score <30. TTR-W was analyzed in previously working or studying patients and measured from the end of treatment until the first documented work or education. We compared duration of treatment on TTR-F and TTR-W using Cox proportional hazards regression adjusted for confounding variables. RESULTS: HRQoL questionnaires at baseline were available in 1632 (83.9%) of all randomized patients. Overall, higher baseline fatigue and age were significantly associated with longer TTR-F and TTR-W and male sex with shorter TTR-W. Treatment reduction from eight to four chemotherapy cycles led to a significantly shorter TTR-F [hazard ratio (HR) 1.41, P = 0.008] and descriptively shorter TTR-W (HR 1.24, P = 0.084) in PET-2-negative patients. Reduction from six to four cycles led to non-significant but plausible intermediate accelerations. The addition of rituximab caused significantly slower TTR-F (HR 0.70, P = 0.0163) and TTR-W (HR 0.64, P = 0.0017) in PET-2-positive patients. HRQoL at baseline and age were the main determinants of 2-year HRQoL. CONCLUSIONS: Individualized first-line treatment in patients with advanced-stage HL considerably shortens TTR-F and TTR-W in PET-2-negative patients. Our results support the use of response-adapted shortened treatment duration for patients with HL.
Department of Hematology and Oncology Klinikum der Philipps Universität Marburg Marburg
Department of Internal Medicine 3 University Hospital of Ulm Ulm Germany
Department of Internal Medicine 5 University of Heidelberg Heidelberg Germany
Department of Nuclear Medicine University Hospital of Cologne Cologne
Department of Oncology and Hematology Helios Klinikum Bad Saarow Bad Saarow
Department of Radiooncology Marienhospital Herne Ruhr University Bochum Bochum Germany
Department of Radiotherapy University Hospital of Muenster Muenster
German Fatigue Society Cologne
German Hodgkin Study Group Cologne
Illrd Medical Department Paracelsus Medical University Salzburg
Medical Oncology University Hospital of Basel Basel
Oncology and Hematology Kantonsspital Graubuenden Chur Switzerland
Salzburg Cancer Research Institute and AGMT Salzburg Austria
Citace poskytuje Crossref.org
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- $a Ferdinandus, J $u Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne. Electronic address: justin.ferdinandus@uk-koeln.de
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