Do elderly colorectal cancer patients experience more deterioration in health- related quality of life during the first year of palliative chemotherapy? – A prospective real-world observational study

Abstract Purpose: The primary aim was to evaluate changes in health-related quality of life (HRQoL) in a real-life population among younger (< 70 years) and older patients with metastatic colorectal cancer (mCRC) the first year of palliative chemotherapy. The secondary aims were to assess the impact of chemo-break on HRQoL and to report overall survival (OS). Methods: Patients with newly diagnosis of mCRC, ≥ 18 years and scheduled for first line palliative chemotherapy, were included in this multicentre longitudinal observational study. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (0-100) was filled in at baseline and every second month, and >20 points change was considered to be of a large clinical magnitude. Treatments, patient- and tumour characteristics were prospectively registered. Results: Totally 214 patients were included, and 146 were alive after one year. Four months after start of treatment, 40% reported large deteriorations in fatigue and 25% in physical functioning. Changes in global Qol, physical- and role functioning, fatigue, pain, nausea and vomiting were not significantly different between the age groups and reached baseline levels after one year. Patients on chemo-break reported significant improvements in several HRQoL domains. Median OS was 17.5 months [95% CI 14.4-20.5] with no difference between younger and older patients. Conclusion: Elderlypatients did not experience more deterioration in HRQoL than younger during the first year of palliative chemotherapy. Measures to mitigate the deterioration in fatigue and physical functioning observed during the first months of palliative treatment are warranted. Trial registration: NCT02395224 , March 23, 2015, retrospectively registered.