***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 Abstract Objective : To compare chemotherapy given at home with outpatient treatment in terms of  colorectal cancer patients ' safety , compliance , use of health services , quality of life , and satisfaction with treatment . Design : R and omised controlled trial . Setting : Large teaching hospital . Participants : 87 patients receiving adjuvant or palliative chemotherapy for colorectal cancer . Interventions : Treatment with fluorouracil ( with or without folinic acid or levamisole ) at outpatient clinic or at home . Main outcome measures : Treatment toxicity ; patients ' compliance with treatment , quality of life , satisfaction with care , and use of health re sources . Results : 42 patients were treated at outpatient clinic and 45 at home . The two groups were balanced in terms of age , sex , site of cancer , and disease stage . Treatment related toxicity was similar in the two groups ( difference 7 % ( 95 % confidence interval −12 % to 26 % ) ) , but there were more voluntary withdrawals from treatment in the outpatient group than in the home group ( 14 % v 2 % , difference 12 % ( 1 % to 24 % ) ) . There were no differences between groups in terms of quality of life scores during and after treatment . Levels of patient satisfaction were higher in the home treatment group , specifically with regard to information received and nursing care . There were no significant differences in use of health services . Conclusions : Home chemotherapy seemed an acceptable and safe alternative to hospital treatment for patients with colorectal cancer that may improve compliance and satisfaction with treatment . What is already known on this topic Home chemotherapy programmes have been proposed as an alternative to hospital treatment However , they are more costly , and there is little evidence on their impact on outcomes such as compliance , quality of life , or use of other health services What this study adds Home chemotherapy was not associated with an increased use of health services such as primary care or emergency departments Home chemotherapy had no effect on patients ' quality of life but increased their compliance with treatment and satisfaction , particularly with regard to nursing care Home chemotherapy seems an acceptable and safe alternative to outpatient treatment that may improve compliance with The aims of our study were to assess the effect of follow-up on the quality of life of colorectal cancer patients and to assess the attitudes of patients towards follow-up as a function of patient characteristics . Patients who had been treated with curative intent were selected from four types of hospitals . Eighty-two patients were interviewed using a structured question naire , whereas 130 patients received the question naire by mail .  To assess the effect of follow-up on the quality of life , the interviewed patients were r and omly allocated to three groups and interviewed at different times in relation to the follow-up visit . Analysis did not show an effect of the follow-up visit on quality of life . Patients reported a positive attitude towards follow-up : it reassured them , they judged the communication with the physician to be positive , and they experienced only slight nervous anticipation and few other disadvantages . Patients reported a strong preference for follow-up , and a large majority would prefer follow-up even if it would not lead to earlier detection of a recurrence . Apart from living situation , no patient characteristics were clearly associated with the attitude towards follow-up . Implication s for clinical practice are discussed BACKGROUND Heterogeneous results for research investigating health-related quality of life ( HRQL ) in patients undergoing sphincter-ablating procedures for rectal cancer are likely due to single institution experiences and measurement of HRQL . To address this heterogeneity , we evaluated HRQL in patients with rectal cancer by type of surgery , location of tumor , and receipt of adjuvant therapy using an HRQL instrument that has not been used to address rectal cancer patients in a population -based sample over time . METHODS The Functional Assessment of Cancer Therapy-Colorectal instrument was administered at 9 and 19 months after diagnosis to a consecutive sample of 160 patients in Northern California identified by the California Cancer Registry . A broad multidimensional interpretation of HRQL was used to examine the impact of tumor location and treatment status , stage of disease , age , and gender . RESULTS In general , men had lower social well-being scores , and younger patients had lower physical and emotional well-being scores and colorectal concerns scores . We found no differences in HRQL by either tumor location or type of surgery , at either 9 or 19 months after diagnosis . Lower physical well-being and greater adverse colorectal concerns were reported at 9 months among patients who received adjuvant therapy ; however , only adverse colorectal concerns persisted over time . CONCLUSIONS This study provides additional evidence that sphincter-ablating procedures do not necessarily reduce quality of life in patients with rectal cancer . Distinctive features of this study include a broad multidimensional interpretation of HRQL , the 19 months of longitudinal follow-up , and a prospect i ve population -based study design Objective : The purpose of this study was to define the association between pretreatment health-related quality of life ( HRQL ) and surgical complications for patients with colorectal cancer . Summary Background Data : For patients with colorectal cancer , surgical complications arise from an interaction between underlying medical comorbidity , colorectal cancer severity , and quality and type of treatment provided . Measurement of HRQL provides a summarization of well-being in the context of medical comorbidity and colorectal cancer severity . The summarization of these factors may be useful in prospect i ve risk assessment of patients about to undergo surgery for colorectal cancer . Methods : A single-institution , prospect i ve , cohort study of patients with colorectal adenocarcinoma was performed from August 1 , 1999 , to March 31 , 2002 . Before treatment , all participants completed  Medical Outcomes Survey SF-36 ( SF-36 ) ; after the first year of the study , patients also completed the colorectal cancer module of the Functional Assessment of Cancer Therapy survey ( FACT-C ) . Information was collected on demographics , treatment , tumor variables , and complications . Results : Ninety-seven patients have undergone open resection of their colorectal cancer . All patients completed SF-36 ; 65 completed FACT-C. Thirty patients ( 31 % ) experienced complications , including 4 ( 4 % ) deaths . Age , race , albumin level , American Society of Anesthesia class , specialty surgical training , tumor location , and stage were not associated with complications in univariate analysis . Patients experiencing surgical complications had significantly lower HRQL scores on SF-36 Social Functioning , General Health Perception , and Mental Health Index scales as well as the Mental Health Component summary score . FACT-C Social/Family , Emotional , Functional Well-Being scores , and the Colorectal Cancer Concerns score were also significantly lower for patients sustaining complications . When these HRQL scales were examined in a multivariate model including albumin level , tumor location , and ASA class , SF-36 Social Functioning ( Odds Ratio [ OR ] = 0.98 ; 95 % Confidence Interval [ CI ] = 0.97–0.99 ) and FACT-C Colorectal Cancer Concerns ( OR = 0.89 ; 95 % CI = 0.79–0.99 ) scales retained a significant association with complications . Conclusions : Pretreatment HRQL scores as measured by several scales of SF-36 and FACT-C were significantly associated with complications . Future studies should concentrate on defining the predictive role of HRQL in determining surgical outcome for patients with colorectal cancer 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 Effects of variations in agent , dose , and route of treatment administration on patient reported quality of life ( QOL ) were examined for 279 patients enrolled on a seven-arm r and omized clinical trial ( S8905 ) of 5-FU and its modulation for advanced colorectal cancer . Patients completed QOL question naires at r and omization and weeks 6 , 11 , and 21 post-r and omization with five QOL endpoints considered primary : three treatment-specific symptoms ( stomatitis , diarrhea , and h and /foot sensitivity ) ; physical functioning ; and emotional functioning . Patient compliance with the QOL assessment schedule was good , supporting the feasibility of including QOL measures in cooperative group trials . However , death and deteriorating health produced substantial missing data . Cross-sectional analyses indicated that the seven therapeutic arms did not differ in their impact on QOL . Unfortunately , longitudinal analyses of the QOL data were inappropriate given non-r and om missing data . Graphical presentation of non-r and om missing data identified the seriousness of this problem and its effect on potential conclusions about QOL during treatment . This problem appears to be particularly challenging in the context of advanced-stage disease . Failure to recognize the presence of non-r and om missing data can lead to serious overestimates of patient QOL over time The aim of the study was to evaluate the effects of the use of progressive muscle relaxation training ( PMRT ) on anxiety and quality of life in colorectal cancer patients after stoma surgery . A r and omised controlled trial was used with repeated measures assessment over 10 weeks post-stoma surgery . Fifty-nine patients participated in the study and were r and omised to a  control group receiving routine care ( n=30 ) and an  experimental group receiving routine care and PMRT  through  two teaching sessions and practice at home for the first 10 weeks . The State-Trait Anxiety Inventory and two Quality of Life Scales were used to collect the data of interest in three occasions , namely during hospitalisation , at week 5 and at week 10 post-surgery . The use of PMRT significantly decreased state anxiety and improved generic quality of life in the experimental group ( P<0.05 ) , especially in the domains of physical health , psychological health , social concerns and environment . Social relationships decreased in both groups . In relation to the disease-specific quality of life measure , differences were observed only in the 10-week assessment , with the experimental group reporting better quality of life at 10 weeks , but not over time as compared to the control group . The use of PMRT should be incorporated in the long-term care of colorectal cancer patients , as it can improve their psychological health and quality of life . This may be a cost-effective intervention that needs minimal training and could easily be offered to those patients that they would like to use it as part of the specialist care provided to stoma patients PURPOSE AND BACKGROUND We examined whether patients with colon cancer undergoing surgery with or without adjuvant chemotherapy  change the internal st and ards on which they base their quality -of-life ( QL ) estimation , and , if they do so , whether this reframing alters interpretation of QL findings . These questions were addressed within a r and omized clinical trial of the Swiss Group for Clinical Cancer Research ( SAKK 40/93 ) . PATIENTS AND METHODS After radical resection of adenocarcinoma of the colon ( pT1 - 4pN > 0M0 and pT3 - 4pN0M0 ) and perioperative chemotherapy , 
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The findings indicated that patients with colorectal cancer continue to suffer from depression , distress and bowel related problems such as constipation and diarrhoea which impacted their quality of life .
European Organisation for Research and Treatment of Cancer ( EORTC ) Quality of Life Question naire , Core Module ( QLQ-C30 ) , European Organisation for Research and Treatment of Cancer ( EORTC ) Colorectal Cancer-Specific Quality of Life Question naire Module ( QLQ-CR38 ) and Short Form 36 were the commonly used instruments to assess QoL in this review and most of the instruments included psychological , physical , social and functional aspects .
Younger colorectal cancer patients had poorer quality of life when compared to elderly patients  .
Colorectal cancer also had a greater impact on quality of life outcomes in women when compared to men .
Psychosocial factors have a great impact on patients ' perceived quality of life .