Abstract 108P
Background
Total neoadjuvant treatment (TNT) has revolutionized the treatment algorithm in the management of Locally Advanced carcinoma rectum (LARC). This increase in the lifespan of cancer warriors should be translated in an improved quality of life so as to have a holistic treatment approach.
Methods
Prospective study of LARC patients (n=39) undergoing Total Neoadjuvant Therapy: SCRT 25Gy/5# followed by 6 cycles of NACT followed by surgery. Quality of life analysed at 3 months and 6 months post treatment using EORTC QLQ C30 and CR29 questionnaire. Wilcoxon Signed Rank test used to analyze mean scores of Health Related Quality of life (HRQL) between 3 and 6 months as Global Health Status, 5 functional scales (Physical, Role, Emotional, Cognitive, Social Functioning) and Symptoms scales.
Results
Global health status showed a statistically significant difference (p=0.001) along with a minor clinical improvement. Under functional items, physical functioning (p<0.01), Role functioning (p=0.03), Emotional Functioning (p=0.01) and Social Functioning (p=0.01) all showed statistically significant difference with clinical improvement. Under Symptoms items, Pain (p=0.02), Diarrhea (p=0.01), abdominal pain (p<0.01), flatulence (p=0.01), buttock pain(p=0.02), bloating (p=0.046), blood and mucus in stools (p=0.001) and stool frequency (p=0.03) all showed a statistically significant difference and clinical reduction of scores.Subgroup analysis showed patients with TNT to surgery time period between 42 to 56 days had a higher difference in global health status than who had <42 days or >56 days (p=0.023).
Conclusions
As per the best of my knowledge this is the first prospective study assessing the Quality of life in India for LARC patients undergoing Total Neoadjuvant Therapy. This study shows a statistical and clinically improvement in Global Health status with the improvement in Functional status of QOL. There is also a statistically significant decrease in symptoms scales which is corroborated with clinical improvement. TNT improves both the survival along with acceptable and improved quality of life, thus making it a comprehensive treatment option for LARC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
All India Institute of Medical Sciences (AIIMS) Bhubaneswar.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.