***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 
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    Input: With the growing number of patients surviving cancer , there has been an increasing concern with their long-term adaptation . Given the large number of Hodgkin 's disease survivors , it was possible to conduct a study of their psychosocial adaptation . Two hundred seventy-three survivors of advanced Hodgkin 's disease were interviewed over the telephone concerning the impact of cancer upon their lives , in terms of their psychological , social , and sexual functioning . The level of psychological distress was elevated by one st and ard deviation above normal on the Brief Symptom Inventory ( BSI ) , for both men and women . Survivors in greater distress reported more problems in other areas of functioning , including sexual , social , vocational , and persistent conditioned nausea We evaluated 4 different health‐related quality of life ( HRQL ) measures prospect ively to determine their ability to detect change over time : the Health Utilities Index Mark 2 and Mark 3 , the Pediatric Quality of Life Inventory ( PedsQL ) 4.0 Generic Core and Cancer Module , the EuroQol EQ‐5D visual analogue scale ( EuroQol ) , and the Lansky Play‐Performance Scale 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 The objective of this study was to evaluate the health-related quality of life ( HRQOL ) of lymphoma survivors , to compare it with that of the general population , and to identify its predictors in lymphoma survivors . We enrolled 837 participants ( mean age , 54.6 years ; mean time since diagnosis , 6.3 years ) with a history of Hodgkin ’s lymphoma ( HL ) ( n = 58 ) or non-Hodgkin ’s lymphoma ( NHL ) ( n = 779 ) who had been treated at any of three Korean hospitals from 1989 through 2010 . For controls , we selected 1,000 subjects r and omly from a representative Korean population . We administered the European Organization for Research and Treatment of Cancer Quality of Life Question naire Core 30 and the Hospital Anxiety and Depression Scale .  Overall , the HRQOL in both groups of survivors and the general population were comparable , but we observed clinical ly meaningful worse social functioning in NHL survivors ( p < 0.001 ) and more severe fatigue in HL survivors ( p < 0.001 ) than in the general population . Analysis of covariance revealed no clinical ly meaningful difference in HRQOL associated with age or sex . Survivors who received peripheral blood stem cell transplants showed clinical ly meaningful worse role ( p = 0.001 ) and social ( p < 0.001 ) functioning than those who were treated with first-line chemotherapy alone . In multivariate analyses , fatigue , depression , and financial difficulties emerged as the strongest predictors for almost all subscales of functioning and global quality of life . Interventions for alleviating fatigue , depression , and financial difficulties are needed to enhance the HRQOL of Korean lymphoma survivors 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 BACKGROUND AND METHODS MOPP ( mechlorethamine , vincristine , procarbazine , and prednisone ) has been the st and ard treatment for Hodgkin 's disease for almost 20 years . In a r and omized , multicenter trial , we compared three regimens of primary systemic therapy for newly diagnosed advanced Hodgkin 's disease in Stages IIIA2 , IIIB , and IVA or IVB : ( 1 ) MOPP alone given for 6 to 8 cycles , ( 2 ) MOPP alternating with ABVD ( doxorubicin , bleomycin , vinblastine , and dacarbazine ) for 12 cycles , and ( 3 ) ABVD alone for 6 to 8 cycles . Patients in a first relapse after radiation therapy were eligible . No additional radiation therapy was given . Patients who did not have a complete response or who had a relapse with either MOPP alone or ABVD alone were switched to the opposite regimen . RESULTS Of 361 eligible patients , 123 received MOPP , 123 received MOPP alternating with ABVD , and 115 received  ABVD alone . The patients were stratified according to age , stage , previous radiation , histologic features , and performance status . The overall response rate was 93 percent , with complete responses in 77 percent : 67 percent in the MOPP group , 82 percent in the ABVD group , and 83 percent in the MOPP-ABVD group ( P = 0.006 for the comparison of MOPP with the other two regimens , both of which contained doxorubicin ) . The rates of failure-free survival at five years were 50 percent for MOPP , 61 percent for ABVD , and 65 percent for MOPP-ABVD . Age , stage ( III vs. IV ) , and regimen influenced failure-free survival significantly . Overall survival at five years was 66 percent for MOPP , 73 percent for ABVD , and 75 percent for MOPP-ABVD ( P = 0.28 for the comparison of MOPP with the doxorubicin regimens ) . MOPP had more severe toxic effects on bone marrow than ABVD and was associated with greater reductions in the prescribed dose . CONCLUSIONS In this trial , ABVD therapy for 6 to 8 months was as effective as 12 months of MOPP alternating with ABVD , and both were superior to MOPP alone in the treatment of advanced Hodgkin 's disease . ABVD was less myelotoxic than MOPP or ABVD alternating with MOPP 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 
    Output:
    
Emphasis on HRQL following therapy may inform initial treatment decisions and long-term survivorship goals .