Background: Colorectal cancer (CRC) is prevalent in the developed world. Favourable survival rates highlight the need to better understand CRC survivors' experiences of long-term impacts of treatment, which can in turn inform decision making. This systematic review aimed to identify and synthesise CRC survivors' experiences of long-term impacts on health-related quality of life. Methods: We searched Medline, Embase and PsychINFO from inception to January 2019. Qualitative studies describing CRC survivors' experiences at least 1-year post-treatment were included. Study eligibility, quality assessment (COREQ guidelines), and data synthesis was performed independently by two reviewers and discussed with the study team. Results: Of 1363 papers retrieved, 20 reporting 15 studies met eligibility. Thematic synthesis produced 12 themes: symptoms, physical, social, psychological and sexual functioning, impact on relationships, informal care needs provided by family/friend, supportive care needs provided by healthcare professional, health care experiences, health behaviour, financial toxicity and occupational experiences. Stoma problems (e.g. leakage, skin irritation) were common in ostomates. Survivors with no/reversed stoma experienced unexpected, longterm altered and unpredictable bowel functioning. Survivors often regulated timing, amount and foods consumed to manage bowel functioning. Less common symptoms included fatigue, impaired sleep and anal pain. Stoma problems and altered bowel functioning impaired survivors' physical, social, sexual and psychological functioning. Cognitive functioning and heredity issues were not reported in any paper. Conclusion: CRC survivors experience ongoing symptoms and functioning impairments more than 1-year posttreatment completion. Many survivors find their own ways to manage symptoms rather than seek professional help. Follow-up care for CRC survivors should integrate screening for long-term effects and provide targeted supportive care.
received P+AI (94.2% 1st line; 5.8% ≥2 nd line) and 741 pts received P+F (51.1% 1 st line; 48.9% ≥2 nd line). Mean (SD) age at palbociclib initiation was 62.3 (10.6) years for P+AI and 64.0 (10.0) years for P+F pts. Most pts had a performance status (ECOG) at palbociclib initiation of 0 or 1 (P+AI: 86.4%; P+F: 87.7%). Of those pts with metastatic disease (P+AI: n = 906; P+F: n = 661), 49.2% P+AI and 48.7% P+F pts had visceral disease; 43.5% P+AI and 39.5% P+F pts had bone only metastases.Median follow-up duration from palbociclib initiation was 10.5 months for P+AI and 8.0 months for P+F patients. Overall 80.3% P+AI and 77.5% P+F pts were still on treatment at the time of data collection. Of those initiating at 125 mg/day (P+AI: n = 922, 93.9%; P+F: n = 668, 90.1%), dose reductions occurred in 18.8% P+AI and 11.9% P+F pts. The 12-and 24-month PFR and SR across lines of therapy are presented in Table 1. Pts receiving P+F 1 st line had higher PFR and SR than those receiving 2 nd line or later. PFR and SR outcomes were favorable across subgroups including pt age, ECOG score at palbociclib initiation, visceral status and time from initial to ABC/MBC diagnosis.
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