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However, limited knowledge exists about pelvic cancer survivors\u2019 LRTI symptoms, distress, and health-related quality of life (HRQOL). We sought to assess the symptom burden, distress, and HRQOL in survivors with established pelvic LRTIs compared to norm populations and to investigate the relation between these factors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Cancer survivors referred for treatment of established pelvic LRTIs were recruited nationwide. LTRIs were assessed with the Expanded Prostate Cancer Index Composite (EPIC), psychological distress was assessed with the General Health Questionnaire (GHQ-12), and HRQOL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORCT-QLQ-C30).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 107 participants (mean age 64, 53% men) were included. Compared to norms, participants reported more urinary (mean 68.7 vs. 89.5; <jats:italic>p<\/jats:italic>\u2009=\u20090.00; <jats:italic>d<\/jats:italic>\u2009=\u20091.4) and bowel symptoms (mean 62.5 vs. 92.4; <jats:italic>p<\/jats:italic>\u2009=\u20090.00; <jats:italic>d<\/jats:italic>\u2009=\u20092.7), increased psychological distress (mean 13.4 vs. 10.3; <jats:italic>p<\/jats:italic>\u2009=\u20090.00; <jats:italic>d<\/jats:italic>\u2009=\u20090.6), and overall poorer HRQOL (mean 54.9 vs. 71.2; <jats:italic>p<\/jats:italic>\u2009=\u20090.00; <jats:italic>d<\/jats:italic>\u2009=\u20090.7). Higher symptom burden and higher levels of psychological distress were associated with lower HRQOL (<jats:italic>r<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200946%), but psychological distress did not moderate the influence of symptoms on HRQOL.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Cancer survivors with established pelvic LRTIs are highly burdened compared to norms. The association of the LRTI-related symptom burden with HRQOL is independent of the level of psychological distress. Both coping and treatment interventions are crucial to promoting long-term health and HRQOL.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>NCT03570229.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00520-021-06684-x","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T09:02:46Z","timestamp":1636966966000},"page":"2477-2486","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Symptom burden, psychological distress, and health-related quality of life in cancer survivors with pelvic late radiation tissue injuries"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8252-7134","authenticated-orcid":false,"given":"Grete K.","family":"Velure","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0538-2848","authenticated-orcid":false,"given":"May Aa.","family":"Hauken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"6684_CR1","unstructured":"Larsen IK (2018) Cancer in Norway 2018 - cancer incidence, mortality, survival and prevalence in Norway, Cancer Registry of Norway, 2019. https:\/\/cin2018.pdf (kreftregisteret.no) Assessed 31 Mar 2021"},{"key":"6684_CR2","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.clon.2013.08.003","volume":"26","author":"E Adams","year":"2014","unstructured":"Adams E, Boulton MG, Horne A, Rose PW, Durrant L, Collingwood M, Oskrochi R, Davidson SE, Watson EK (2014) The effects of pelvic radiotherapy on cancer survivors: symptom profile, psychological morbidity and quality of life. 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