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@ARTICLE{Kosmala:301582,
      author       = {R. Kosmala and A. S. Hammann and P. Paulus and M.
                      Zimmermann and A. Wittig-Sauerwein and C.-T. Germer and M.
                      Ghadimi and R.-D. Hofheinz and M. Diefenhardt and E.
                      Fokas$^*$ and C. Rödel$^*$ and B. Polat},
      collaboration = {G. R. C. S. Group},
      title        = {{Q}uality of life after two sequences of total neoadjuvant
                      treatment in patients with locally advanced rectal cancer in
                      the randomized {CAO}/{ARO}/{AIO}-12 phase 2 trial.},
      journal      = {International journal of radiation oncology, biology,
                      physics},
      volume       = {nn},
      issn         = {0360-3016},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2025-01090},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {In a multicenter phase 2 trial the sequence of
                      chemoradiotherapy (CRT) followed by consolidation
                      chemotherapy (CT) prior to total mesorectal excision
                      demonstrated higher pathological complete response rates
                      than induction CT before CRT. Here, we present findings on
                      quality of life (QoL).Patients with rectal carcinoma (cT3-4
                      cN0-2) were randomly assigned to group A (CT+CRT; N=156) or
                      group B (CRT+CT; N=150). This is a secondary QoL analysis
                      (EORTC QLQ-C30+CR29, Wexner) before and during treatment and
                      of disease-free patients during follow-up.gov identifier:
                      XXXX.At baseline, completed questionnaires were available
                      for $86\%$ (N=134/156; group A) and $89\%$ (N=133/150; group
                      B) of participants, with availability decreasing to $73\%$
                      versus $64\%$ at 1 year, $61\%$ versus $59\%$ at 2 years,
                      and $51\%$ versus $47\%$ at 3 years. Global health status
                      remained stable in both groups (range 0-100) with baseline
                      scores of 65.2 (mean, SD=21.5; N=133; group A) and 64.7
                      (SD=23.2; N=131; group B) and with scores of 67.6 (SD=18.4;
                      N=52) and 65.4 (SD=22.2; N=46), respectively, at 3 years. No
                      statistically or clinically relevant differences were
                      observed between groups in any QoL scale upon treatment
                      completion or during follow-up. Both groups experienced
                      declines in role functioning, body image, male impotence,
                      and stool incontinence (Wexner), which did not fully recover
                      over the follow-up period. Rectal blood/mucus discharge and
                      anxiety improved during treatment.QoL did not differ between
                      the two total neoadjuvant treatment sequences. QoL domains
                      with long lasting deterioration may serve as endpoints in
                      future studies focused on organ preservation.},
      keywords     = {Quality of life (Other) / chemoradiotherapy (Other) /
                      clinical trial (Other) / radiotherapy (Other) / rectal
                      neoplasms (Other)},
      cin          = {FM01},
      ddc          = {610},
      cid          = {I:(DE-He78)FM01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40409541},
      doi          = {10.1016/j.ijrobp.2025.05.018},
      url          = {https://inrepo02.dkfz.de/record/301582},
}