Health status and quality of life in patients with early-stage Hodgkin's disease treated on Southwest Oncology Group Study 9133

Patricia A. Ganz, Carol M. Moinpour, Donna K. Pauler, Alice B. Kornblith, Ellen R. Gaynor, Stanley P. Balcerzak, Gretchen S. Gatti, Harry P. Erba, Sheryl McCoy, Oliver W. Press, Richard I. Fisher

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Abstract

Purpose: We describe the short and intermediate-term quality-of-life (QOL) outcomes in patients treated on a randomized clinical trial in early-stage Hodgkin's disease (Southwest Oncology Group [SWOG] 9133) comparing subtotal lymphoid irradiation (STLI) with combined-modality treatment (CMT). Patients and Methods: Two hundred forty-seven patients participated in the QOL study (SWOG 9208), completing several standardized instruments (Symptom Distress Scale; Cancer Rehabilitation Evaluation System - Short Form; Medical Outcomes Study 36-Item Short-Form Health Survey Vitality Scale; and a health perception item), as well as questions about work, marital status, and concerns about having children. This article reports on results from baseline before random assignment, at 6 months, and at 1 and 2 years after random assignment. Results: Patients receiving CMT experienced significantly greater symptom distress (P < .0001), fatigue (P = .001), and poorer QOL (P = .015) at 6 months than the STLI patients, reflecting a shorter time since completion of therapy in the CMT arm. Importantly, patients in the two groups did not differ on any outcomes at the 1 -and 2-year assessments. Both patient groups reported significantly more fatigue before treatment than healthy reference populations, and fatigue did not improve in either group after treatment. Conclusion: This study demonstrated that patients with early-stage Hodgkin's disease experience a short-term decrease in QOL and an increase in symptoms and fatigue with treatment, which is more severe with CMT; by 1 year, however, CMT and STLI patients report similar outcomes. Fatigue scores for both arms were lower at baseline than scores for the general population and did not return to normal levels 2 years after random assignment. The mechanisms responsible for this lingering problem warrant further investigation.

Original languageEnglish (US)
Pages (from-to)3512-3519
Number of pages8
JournalJournal of Clinical Oncology
Volume21
Issue number18
DOIs
StatePublished - Sep 15 2003

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Ganz, P. A., Moinpour, C. M., Pauler, D. K., Kornblith, A. B., Gaynor, E. R., Balcerzak, S. P., Gatti, G. S., Erba, H. P., McCoy, S., Press, O. W., & Fisher, R. I. (2003). Health status and quality of life in patients with early-stage Hodgkin's disease treated on Southwest Oncology Group Study 9133. Journal of Clinical Oncology, 21(18), 3512-3519. https://doi.org/10.1200/JCO.2003.01.044