% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @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}, }