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| Item Type: | Article |
|---|---|
| Title: | Impact of individualized treatment on recovery from fatigue and return to work in survivors of advanced stage Hodgkin Lymphoma: results from the randomized international GHSG HD18 trial |
| Creators Name: | Ferdinandus, J. and Müller, H. and Damaschin, C. and Jacob, A.S. and Meissner, J. and Krasniqi, F. and Mey, U. and Schöndube, D. and Thiemer, J. and Mathas, S. and Zijlstra, J. and Greil, R. and Feuring-Buske, M. and Markova, J. and Rüffer, J.U. and Kobe, C. and Eich, H.T. and Baues, C. and Fuchs, M. and Borchmann, P. and Behringer, K. |
| Abstract: | BACKGROUND: Persisting cancer-related fatigue impairs health related quality of life (HRQoL) and social re-integration in patients with Hodgkin lymphoma (HL). The GHSG HD18 trial established PET-2 guided treatment de-escalation for advanced-stage HL as new standard. Here, we investigate the impact of treatment de-escalation on long-term HRQoL, time-to-recovery from fatigue (TTR-F) and time-to-return to work (TTR-W). PATIENTS AND METHODS: Patients received EORTC QLQ-C30 and life situation questionnaires at baseline, interim, end-of-treatment, and yearly follow-up. TTR-F was defined as time from end of chemotherapy until the first fatigue score < 30. TTR-W was analyzed in previously working or studying patients and measured from end of treatment until first documented work or education. We compared duration of treatment on TTR-F and TTR-W using Cox proportional hazards regression adjusted for confounding variables. RESULTS: HRQoL questionnaires at baseline were available in 1632 (83.9%) of all randomized patients. Overall, higher baseline fatigue and age were significantly associated with longer TTR-F and TTR-W and male sex with shorter TTR-W. Treatment reduction from eight to four chemotherapy cycles led to a significantly shorter TTR-F (HR 1.41, p=0.008) and descriptively shorter TTR-W (HR 1.24, p=0.084) in PET-2 negative patients. Reduction from six to four cycles led to non-significant but plausible intermediate accelerations. Addition of Rituximab caused significantly slower TTR-F (HR 0.70, p=0.0163) and TTR-W (HR 0.64, p = 0.0017) in PET-2 positive patients. HRQoL at baseline and age were the main determinants of 2y HRQoL. CONCLUSIONS: Individualized first-line treatment in patients with advanced-stage HL considerably shortens TTR-F and TTR-W in PET-2 negative patients. Our results support the use of response-adapted shortened treatment duration for patients with HL. |
| Keywords: | Hodgkin Lymphoma, Fatigue, Return to Work, Recovery, Quality of Life, Survivorship |
| Source: | Annals of Oncology |
| ISSN: | 0923-7534 |
| Publisher: | Oxford University Press |
| Volume: | 35 |
| Number: | 3 |
| Page Range: | 276-284 |
| Date: | March 2023 |
| Official Publication: | https://doi.org/10.1016/j.annonc.2023.11.014 |
| PubMed: | View item in PubMed |
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