***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To evaluate late psychosocial sequelae in long-term survivors of Hodgkin 's disease ( HD ) in the population of Calvados , France . PATIENTS AND METHODS Ninety-three patients issued from the Calvados General Tumor Registry , treated from 1978 to 1990 , free of relapse and second malignancy since January 1991 , were enrolled onto cross-sectional case-control study . One hundred eighty-six healthy controls , matched for sex , age , and residency , were selected at r and om from electoral rolls . Two self-administered question naires were mailed in the spring of 1995 . RESULTS Compared with controls , HD patients reported ( 1 ) more physical ( P < .001 ) , role ( P < .001 ) , and cognitive ( P = .015 ) functioning impairments , as well as dyspnea ( P < .001 ) and chronic fatigue ( P = .025 ) , while no statistical difference was found in global health status ; ( 2 ) to be more often childless ( P = .04 ) , fewer divorces or separations ( P = .013 ) , fewer changes in relationships with friends ( P = .012 ) , similar proportions at work but less ambitious professional plans ( P < .001 ) , and greater difficulties in borrowing from banks ( P < .001 ) ; ( 3 ) a slight increase in the number of visits to a general practitioner ( P = .05 ) and greater consumption of medical re sources ( mainly thyroid extracts , P = .05 ) . CONCLUSION The study demonstrated that French long-term HD survivors have good global health status and good psychologic , familial , and professional status , although difficulties in borrowing from banks remain a major limitation in daily life . Although physical , role , and cognitive functioning impairments persist that might limit their activities , HD survivors seem to have learned to cope with problems related to their disease and its treatment BACKGROUND Little is known about the longitudinal course of health-related quality of life ( HRQoL ) in patients with Hodgkin 's lymphoma during their post-treatment follow-up and re-adaptation to normal life . We report on the HRQoL of patients treated in the r and omised H8 trial of the European Organisation for Research and Treatment of Cancer ( EORTC ) Lymphoma Group and the Groupe d'Etudes des Lymphomes de l'Adulte ( GELA ) . We aim ed to assess HRQoL and fatigue following treatment , to analyse relations with treatment , and to identify factors that predict persistent fatigue . METHODS Patients received HRQoL question naires at the end of primary therapy and during follow-up . The  EORTC QLQ-C30  was used to assess HRQoL , and the  Multidimensional Fatigue Inventory ( MFI-20 )  was used to assess fatigue . Changes of mean HRQoL scores over time were analysed with mixed models . Multiple polytomic nominal logistic regression was done to identify independent baseline predictors of fatigue within MFI-20 dimensions . Analyses were done on an intention-to-treat basis . This study is registered with www . Clinical Trials.gov , number NCT00379041 . FINDINGS 2666 assessment s from 935 patients were analysed . Mean follow-up was 90 months ( range 52 - 118 ) . Age affected all functioning and symptom scores except emotional functioning , with younger age associated with higher functioning and lower severity of symptoms ; improvement with time showed similar patterns between age groups . Women reported lower HRQoL and higher symptom scores than did men . Overall , 3.2 % ( 14/439 for role functioning ) to 9.7 % ( 43/442 for social functioning ) and 5.8 % ( 29/498 for reduced motivation ) to 9.9 % ( 49/498 for general fatigue ) of patients reported impairments of 10 points or more ( on a 0 - 100 scale ) in QLQ-C30 and MFI-20 scores , respectively , independent of age and sex . Emotional domains were more affected than physical ones . There was no relation between HRQoL outcome and type of treatment . Fatigue ( MFI-20 scores ) at the end of treatment was the only predictive variable for persistent fatigue , with odds ratios varying from 2.58 ( 95 % CI 1.00 - 6.67 ) to 41.51 ( 12.02 - 143.33 ; p</=0.0001 ) . Sensitivity analyses adjusting for missing data were much the same as the main results . INTERPRETATION HRQoL data after treatment for early-stage Hodgkin 's lymphoma show that patients experience strain and limitations in all subdomains apart from cognitive functioning ( QLQ-C30 ) , and also have reduced motivation ( MFI-20 ) . Differences in HRQoL improvement with time were linked to age and sex , but not type of treatment . Fatigue status at the end of treatment seems to predict subsequent HRQoL. FUNDING French Ministry of Health , Programme Hospitalier de Recherche Clinique 1994 , and French National League Against Cancer We studied the impact of CHOP chemotherapy on the quality of life ( QoL ) of elderly patients with aggressive non-Hodgkin 's lymphoma ( NHL ) . 132 patients aged 65 or older , who participated in a r and omized , multicenter trial , completed QoL question naires ( EuroQol-5D , EORTC QLQ-C30 and MFI-20 ) on 8 predefined time-points before , during and following treatment . At baseline , QoL was significantly better on almost all dimensions in patients with a lower compared to patients with a higher age-adjusted International Prognostic Index ( aaPI ) . During treatment , physical and role functioning and global QoL deteriorated and fatigue increased in the lower aaPI group , whereas QoL of the higher aaPI group remained stable . During follow-up , the QoL was significantly better for patients in complete response ( CR ) or partial remission ( PR ) than for patients with progression/relapse . Soon after completion of therapy , the QoL of the lower aaPI group returned to pretreatment levels or better , while patients with higher aaPI showed a significant improvement in QoL compared to baseline levels . The effect of CHOP on the quality of life of elderly patients could be used in counseling this group of patients BACKGROUND AND OBJECTIVES The aim of this study was to evaluate quality of life ( QOL ) in a group of elderly patients ( > 65 years ) with aggressive non-Hodgkin 's lymphoma ( NHL ) treated with chemotherapy regimens containing anthracyclines .  DESIGN AND METHODS QOL was evaluated in a population of elderly patients with aggressive NHL enrolled in a phase III clinical trial run by the Intergruppo Italiano Linfomi ( IIL ) from 1996 to 1999 to compare two different anthracycline-containing regimens ( mini-CEOP vs P-VEBEC ) . The EORTC-QLQ-C30 question naire , which has already been vali date d in oncology , was used . The question naire was administered at the time of diagnosis , half way through the chemotherapy and at the time of restaging . RESULTS Ninety-one patients completed pre-therapy and post-therapy question naires and they are the subject of this report . Baseline QOL assessment showed a strong correlation of poor values of QOL with anemia and high risk according to the International Prognostic Index ( IPI ) . At the end of treatment no functional scales showed worse values . A significant improvement was observed for pain ( p=0.003 ) , appetite ( p=0.006 ) , sleep ( p=0.015 ) and global health ( p=0.027 ) . Considering only the 50 patients who achieved a complete remission ( CR ) , an improvement was also recorded for emotional state ( p=0.10 ) , role ( p=0.05 ) , constipation ( p=0.04 ) and global QOL ( p=0.05 ) . INTERPRETATION AND CONCLUSIONS The EORTC-QLQ-C30 is feasible even in a population of elderly patients , in whom it had never been tested before . The improvement of QOL at the end of the treatment demonstrated that the symptoms of the disease have a greater negative influence on the patient 's life than do the side effects of the therapy PURPOSE We describe the short and intermediate-term quality -of-life ( QOL ) outcomes in patients treated on a r and omized 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 st and ardized 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 r and om assignment , at 6 months , and at 1 and 2 years after r and om assignment . RESULTS Patients receiving CMT  experienced significantly greater symptom distress ( P = .0001 ) , [ corrected ] fatigue ( P = .0001 ) , [ corrected ] 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 assessment s. The study cohort at r and omization exhibited more fatigue [ corrected ] than healthy reference population s. Fatigue levels did not exceed baseline estimates by the end of the study . [ corrected ] . 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 r and om assignment . The mechanisms responsible for this lingering problem warrant further investigation In this study health-related quality of life ( HRQL ) in long-term survivors of Hodgkin 's lymphoma ( HL ) was evaluated and the findings were analyzed using a conceptual model developed by Wilson and Cleary . A better underst and ing of the relationships between the variables explaining HRQL may improve care and rehabilitation of HL patients . The population s were long-term survivors of HL ( n=121 ) and a control group ( n = 236 ) . Participants were approached with one semi-structured interview , an extended version of the Schedule for the Evaluation of Individual Quality of Life – Direct Weighting ( SEIQoL-DW ) and three st and ardized question naires : Hospital Anxiety and Depression ( HAD ) scale , Short Form 12 health survey question naire ( SF-12 ) and  Sense of Coherence ( SOC ) scale . No differences regarding the mean scores were found between the HL survivors and the controls except for the SF-12 , where the patients considered themselves to be in poorer physical health than the controls ( p < 0.01 ) . Even though physical health was diminished , patients did not evaluate overall QoL worse compared to the controls . The major determinants of perception of general QoL were self-rated physical and mental health as well as SOC . The HRQL of persons who have survived a median of 14years with HL is similar to that of controls The primary purpose of this study was to examine differences in quality of life ( QoL ) between non-Hodgkin 's lymphoma ( NHL ) survivors meeting and not meeting public health exercise guidelines . A secondary purpose was to examine exercise behavior changes across three distinct cancer-related time periods ( i.e. prediagnosis , on treatment and off treatment ) . Using a retrospective survey design , 438 NHL survivors residing in Alberta , Canada completed a mailed question naire that assessed self-reported exercise prediagnosis , on treatment and off treatment , and current QoL. Descriptive analyses indicated that 33.8 , 6.5 and 23.7 % of NHL survivors met public health exercise guidelines during prediagnosis , on treatment , and off treatment time periods , respectively . Multivariate analyses of variance indicated that NHL survivors meeting public health exercise guidelines during postdiagnosis time periods had higher current QoL scores than NHL survivors not meeting guidelines . QoL difference scores between the two groups met proposed st and ards for clinical ly important differences . Multivariate analyses also indicated significant differences in exercise behavior across the three cancer-related time periods ( all p's<0.01 ) . These analyses were unchanged after statistically controlling for important medical and demographic variables . The results of this study provide evidence that NHL survivors meeting public health exercise guidelines on and off treatment reported higher current QoL than those survivors not meeting guidelines . These findings corroborate research examining exercise behavior in other cancer survivor groups and provide preliminary data to support a r and omized controlled trial on exercise and QoL in this population This study aim ed to use an individual approach in evaluating QoL in long-term survivors of Hodgkin 's lymphoma ( HL ) and their view of what impact the disease has had on life using an extended version of the The Schedule for the Evaluation of the Individual quality of life-Direct Weighting ( SEIQoL-DW ) . Adult long-term survivors from 
    Output:
    
HL survivors showed the most problems in ( role ) physical , social and cognitive functioning , general health , fatigue and financial problems .
In addition , HL survivors treated with a combination of therapies , with older age and female sex reported worse HRQoL. NHL survivors showed the most problems in physical functioning , appetite loss , vitality and financial problems .
Having had chemotherapy was negatively associated with HRQoL , but no differences in chemotherapy regimens were found .
Furthermore , in NHL survivors not meeting public exercise guidelines , HRQoL is low but can be improved with more exercise .