ArticleCancer management and research2018
The predictive value of cumulative toxicity for quality of life in patients with metastatic colorectal cancer during first-line palliative chemotherapy.
Article in Cancer management and research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Assessment of Food and Drug Administration- and European Medicines Agency-Approved Systemic Oncology Therapies and Clinically Meaningful Improvements in Quality of Life: A Systematic Review.JAMA network open · 2021Pooled it
- Experiences of patients with metastatic colorectal cancer participating in a supervised exercise intervention during chemotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Trial
- Predictors for use of psychosocial services in patients with metastatic colorectal cancer receiving first line systemic treatment.BMC cancer · 2019Trial
- The impact of exercise on tolerability of systemic treatment in metastatic colorectal cancer: A literature review.Journal of cancer survivorship : research and practice · 2026Review
- Under the radar-frequency, timing, duration, and trajectory of lower-grade adverse events in clinical trials of anti-cancer therapies.The oncologist · 2025Article
- Article
- Metagenomic analysis during capecitabine therapy reveals microbial chemoprotective mechanisms and predicts drug toxicity in colorectal cancer patients.medRxiv : the preprint server for health sciences · 2024Article
- The association of health insurance literacy and numeracy with financial toxicity and hardships among colorectal cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Article
- Lipid-Based Drug Delivery Nanoplatforms for Colorectal Cancer Therapy.Nanomaterials (Basel, Switzerland) · 2020Review
- Medication Reconciliation Associated with Comprehensive Geriatric Assessment in Older Patients with Cancer: ChimioAge Study.Clinical interventions in aging · 2020Observational
- Therapeutic Characteristics, Chemotherapy-Related Toxicities and Survivorship in Colorectal Cancer Patients.Ethiopian journal of health sciences · 2020Article
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies evaluating new systemic agents tend to report severe toxicities only, while the cumulative effect of multiple lower grade adverse events (AEs) may have an additional negative impact on patient quality of life (QOL). In the current observational cohort study, we evaluated whether, in patients with metastatic colorectal cancer receiving first-line chemotherapy, cumulative toxicity comprising all grades of AEs is more predictive for QOL than cumulative toxicity due to only high-grade AEs.
methodsOne hundred and five patients starting treatment completed the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) questionnaire at baseline and 10 weeks. AEs, clinical outcomes, and demographics were retrieved from patient records. Cumulative toxicity scores were calculated in three ways: total number of high-grade AEs, total number of all-grade AEs, and total number of AEs multiplied by their grade (the severity score). Relations between cumulative toxicity scores and QOL were studied using multivariable linear regression analyses.
resultsThe mean age of patients was 65 years, 68% were male, and 84% received oxaliplatin-based chemotherapy. A higher total number of AEs of all grades (B=-2.4, 95% CI=-3.9; -0.9) and the severity score (B=-1.4, 95% CI=-2.3; -0.5) were predictive for clinically relevant changes in physical QOL, whereas the total high-grade AEs was not. None of the cumulative toxicity scores were predictive for global QOL.
conclusionCumulative toxicity scores comprising all grades of AEs provide a better measure of treatment burden than a toxicity score comprising high-grade AEs only. Physical QOL seems to be more affected by AEs than global QOL. Our results emphasize that future clinical trials should present cumulative toxicity scores comprising all AE grades as well as physical QOL instead of global QOL.
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