***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: The aim of this study was to assess symptoms and health-related quality of life ( HRQL ) during (neo)adjuvant radiotherapy for rectal cancer . Patients receiving pelvic radiotherapy 50 Gy for rectal cancer , were studied prospect ively ( n=42 ) . The European Organization for Research and Treatment of Cancer ( EORTC ) question naires quality of life-core 30 QLQ-C30 and QLQ-CR38 and a 5-day symptom diary were completed at the start and end of radiotherapy and 4 - 6 weeks later . At the end of radiotherapy , mean scores of diarrhoea , fatigue and appetite loss had significantly increased ( P<0.01 ) compared with pretreatment scores , but this was not observed for scores for nausea or pain . At the end of radiotherapy , diarrhoea , fatigue , appetite loss , physical function , social function and global quality of life ( QL ) were significantly worse than the population -based norms . 64 % of the patients reported an increase in fatigue and 52 % an increase in diarrhoea during radiotherapy . HRQL scores had returned to pre-treatment levels 4 - 6 weeks after radiotherapy . Thus , diarrhoea , fatigue and appetite loss increased transiently during pelvic radiotherapy BACKGROUND Oral capecitabine achieves a superior response rate with an improved safety profile compared with bolus 5-fluorouracil-leucovorin ( 5-FU/LV ) as first-line treatment for patients with metastatic colorectal cancer . We report here the results of a large phase III trial investigating adjuvant oral capecitabine compared with 5-FU/LV ( Mayo Clinic regimen ) in Dukes ' C colon cancer . PATIENTS AND METHODS Patients aged 18 - 75 years with resected Dukes ' C colon carcinoma were r and omized to receive 24 weeks of treatment with either oral capecitabine 1250 mg/m(2 ) twice daily , days 1 - 14 every 21 days ( n = 993 ) , or i.v . bolus 5-FU 425 mg/m(2 ) with i.v . leucovorin 20 mg/m(2 ) on days 1 - 5 , repeated every 28 days ( n = 974 ) . RESULTS Patients receiving capecitabine experienced significantly ( P < 0.001 ) less diarrhea , stomatitis , nausea/vomiting , alopecia and neutropenia , but more h and -foot syndrome than those receiving 5-FU/LV . Fewer patients receiving capecitabine experienced grade 3 or 4 neutropenia , febrile neutropenia/sepsis and stomatitis ( P < 0.001 ) , although more experienced grade 3 h and -foot syndrome than those treated with 5-FU/LV ( P < 0.001 ) . Capecitabine demonstrates a similar , favorable safety profile in patients aged < 65 years or > or = 65 years old . CONCLUSIONS Based on its improved safety profile , capecitabine has the potential to replace 5-FU/LV as st and ard adjuvant treatment for patients with colon cancer . Efficacy results are expected to be available in Keywords : Adjuvant treatment , capecitabine , chemotherapy , colorectal AIMS To investigate early and late complications in 44 patients with locally advanced mid-low rectal cancer enrolled in a phase I-II study , who had received an aggressive chemoradiation treatment ( 50.4Gy/28F ; 5-FU continuous infusion and weekly Oxaliplatin ) followed by total mesorectal excision and 5-FU based postoperative chemotherapy .  The aim of the present study is also to evaluate functional outcome and quality of life ( QoL ) in a sub-group of 22 patients . METHODS St and ardized forms for early and late surgical complications were completed for all patients . Anorectal function and QoL were also investigated in 22 patients who underwent surgery in the same surgical unit , using the fecal incontinence scoring system ( FIS ) and EORTC-QLQ-CR38 question naires , compiled before and after radiotherapy and at least 8 months after surgery . The differences over time in scores were analyzed using repeated measure ANOVA . RESULTS The median age of patients ( 25 males and 19 females ) was 58 ( range : 34 - 73 ) years . A low anterior resection was performed in 39 cases , radical resection in 41 , and 12 patients had a pathological complete response . There were no operative deaths ; 4 and 9 patients required re-operation for early and late complications , respectively . FIS score did not present a significant worsening over time . According to data in the EORTC-QLQ-CR38 question naire , a significant improvement over time was found only for " future perspective " . CONCLUSION Our findings seem to indicate that this aggressive 5-FU-Oxalipaltin-based treatment implies no impairment of QoL and anorectal function , even if a high rate of late major complications was observed . Studies on larger series are required to confirm these results Background The purpose of this multicentric prospect i ve study was to evaluate postoperative HRQL and satisfaction with care after laparoscopic colonic resection for colorectal cancer in elderly patients . Methods A total of 116 patients were enrolled in this study : 33 patients older than age 70 years had laparoscopic colectomy , whereas 24 had open colectomy ; 44 patients younger than age 70 years had laparoscopic colectomy and 15 of them had open colectomy .  The patients answered to three question naires about generic ( EORTC QLQ C30 ) and  disease-specific quality of life  ( EORTC CR29 ) and about  treatment satisfaction  ( EORTC IN-PATSAT32 ) . Nonparametric tests and forward stepwise multiple regression analysis were used for statistical analysis . Results One month after surgery , global quality of life ( QL2 item ) was significantly impaired in elderly patients who had laparoscopic colectomy  compared with younger patients who had the same operation ( p = 0.003 ) . Similarly , role function ( RF ) , physical function ( PF ) , emotional function ( EF ) , cognitive function ( CF ) , and social function ( SF ) were impaired in elderly patients who had laparoscopic colectomy compared with younger patients ( p < 0.001 , p < 0.001 , p = 0.013 , p < 0.001 , p = 0.01 , respectively ) . Fatigue ( FA ) , sleep disturbances ( SL ) , appetite loss ( AP ) , and dyspnea ( DY ) affected the quality of life of these patients more than younger patients ( p < 0.001 , p = 0.055 , p = 0.051 , and p = 0.003 , respectively ) . Conclusions Elderly patients undergoing laparoscopic colectomy for cancer experience less postoperative local complications than elderly patients undergoing open colectomy . Nevertheless , in the first postoperative month , these patients experience a worse global quality of life than younger patients undergoing the same operation with impairment of all the functions and the presence of fatigue , sleep disturbances , appetite loss , and dyspnea BACKGROUND The possible benefit for patients of follow-up examinations after curative surgery for colorectal cancer is at present not proven . The purpose of this study was to evaluate the influence of follow-up examinations on health-related quality of life and to assess the attitude of the patients to check-ups . METHODS A total of 350 patients who had had curative surgery for colorectal cancer and who had been subsequently r and omized to either frequent follow-up or virtually no follow-up  completed the Nottingham Health Profile and a second question naire assessing their attitude to the follow-up visits . RESULTS The patients who were receiving more frequent follow-up had greater confidence in the check-ups , but the improvement in the health-related quality of life was only marginally better than that of those receiving few follow-up visits . CONCLUSION The relatively small benefit for health-related quality of life does not justify expensive frequent routine examinations after surgery for colorectal cancer . The Nottingham Health Profile proved to be a reliable instrument within this patient group PURPOSE : Rectal cancer is the most common reason for a person to undergo  ostomy surgery .  The aim of this study was to assess concerns and health-related quality of life ( HRQOL ) before surgery and during the first 6 months following ostomy surgery in the presence of rectal cancer . SUBJECTS AND SETTING S : The sample comprised 57 patients at a university hospital in Gothenburg , Sweden . Their median age was 66 years ( range , 30–87 ) ; 35 men and 22 women participated in the study . METHODS : Participants prospect ively answered question naires preoperatively , and at 1 , 3 , and 6 months postoperatively . Concerns were assessed using the rating form of the Inflammatory Bowel Disease Patient Concerns , and HRQOL was evaluated using the 36-Item Short Form Health Survey . Results were compared with population norms . RESULTS : Participants expressed concerns associated with developing cancer , being a burden on others , and related to the uncertain nature of disease . Health-related quality of life scores dropped significantly in 6 of 8 domains when preoperative scores were compared to those obtained 1 month postoperatively , but scores improved at 6 months . There were significant differences between preoperative study group scores and population norms on physical and emotional role function , social function , and for mental health domains . Significant differences persisted when population norms were compared to study group scores 6 months following surgery on all these domains except mental health . Participants identified good relations with significant others , social and leisure activities , psychological issues , and health as important for maintaining QOL . Obstacles to maintaining QOL included fatigue , pain , illness-induced limitations in life , and worries over what their new life would entail . CONCLUSION : Surgical management of rectal cancer raises concerns and profoundly impairs QOL during the first several postoperative months Background The relationship between colorectal cancer ( CRC ) risk and physical activity and dietary habits has been well-established , but less is known about the relationship between these behaviours and quality of life ( QOL ) post-diagnosis . Moreover , it is unknown whether this relationship is consistent across cancer stage or treatment setting . Thus , the purpose of this study was to assess current  diet and physical activity behaviour  in CRC survivors receiving systemic chemotherapy  , and to examine potential associations between these behaviours and quality of life . A secondary purpose was to examine the association between social support , diet , and physical activity behaviour in this population . Methods Using a cross-sectional survey , 67 CRC survivors currently receiving chemotherapy in Calgary , Alberta completed the survey package . Measures included demographic and medical data , physical activity levels , diet behaviour , QOL , and social support . Results In a largely metastatic sample ( 63 % ) , approximately half were meeting national dietary guidelines ( 58 % ) , less were meeting national physical activity guidelines ( 26 % ) , and a small number were meeting both ( 17 % ) . However , only 12.3 % ( n = 8) reported completely sedentary behaviour , and 7 of these 8 participants were receiving metastatic treatment . Neither behaviour was significantly associated with QOL or perceived social support . Furthermore , there were no significant QOL differences between those treated with palliative intent or adjuvant therapy . Important group differences emerged between those meeting and not meeting the guidelines , and associations between QOL , age , BMI , and provisions of social support . Conclusion These findings provide insight into lifestyle behaviours of CRC survivors currently receiving systemic chemotherapy , and the differences in perceived QOL as affected by severity of disease and treatment setting . Prospect i ve studies in a larger sample of CRC survivors on chemotherapy are needed to confirm lifestyle behaviour patterns and identify factors related to QOL that are unique to this population , especially during metastatic treatment BACKGROUND Elders undergo approximately 40 % of more than 1 million major abdominal operations annually . Yet evidence about recovery to preoperative levels of functional independence is limited . This study details course and predictors of functional recovery after  elective major abdominal operations in the elderly . STUDY DESIGN This was a prospect i ve cohort of 372 consecutive patients , 60 years old or more , enrolled from surgeons in private practice and two university-affiliated hospitals , assessed preoperatively and postoperatively at 1 , 3 , and 6 weeks , 3 and 6 months , using self-report and performance-based measures ( Activities of Daily Living [ ADL ] , Instrumental Activities of Daily Living [ IADL ] , Medical Outcomes Study Short Form-36 Physical Component and Mental Component Scales [ PCS , MCS ] , Geriatric Depression Scale [ GDS ] , Folstein Mini-Mental State Exam [ MMSE ] , timed walk , functional reach , h and grip strength ) . RESULTS Mean age was 69 + /- 6 years with 56 % men , 47 % nonHispanic Caucasian , and 42 % Mexican American ; hospital distribution was 49 % private , 51 % university-affiliated . Maximum functional declines ( 95 % CI ) occurred 1 week postoperatively : ADL , 2.8 points ( 2.4 to 3.2 ) ; IADL , 7.6 points ( 7 to 8.3 ) ; SF-36 PCS , 6.5 points ( 5.4 to 7.6 ) ; Mini-Mental State Exam , 0.5 points ( 0.2 to 0.7 ) ; timed walk , 6.8 seconds ( 5.2 to 8.4 ) ; functional reach , 1.7 inches ( 1.2 to 2.2 ) ; grip 
    Output:
    
Conclusion In spite of the limitations , it is likely that the physical and functional capacity of CRC survivors deteriorates after treatment .