Assessment of Health-Related Quality of Life after the Second Cycle of Chemotherapy in Esophageal Cancer Patients: A Prospective Cross-Sectional Study

Aim: To evaluate early changes in symptom-specific Health-Related Quality of Life (HRQoL) among Esophageal cancer patients receiving chemotherapy up to the second cycle and to assess demographic and treatment-related differences in early responses. Materials and Methods: A total of 56 patients with histologically confirmed Esophageal cancer were evaluated prospectively before chemotherapy initiation and after the second cycle. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for Esophageal Cancer (EORTC QLQ-OES25). Domain scores were linearly transformed to a 0-100 scale according to the EORTC scoring manual, and changes from baseline to the second cycle were analyzed using paired t-tests and Pearson correlation. Results: The majority of patients were aged 45-64 years (57%) and male (66%). Stage III disease was most common (48%), and 77% received palliative chemotherapy. The mean overall symptom-specific HRQoL score improved modestly from 59.75±16.48 at baseline to 61.80±17.18 after the second cycle (p=0.032). Younger patients (25-44 years), females, and those receiving adjuvant therapy showed the greatest improvements. The correlation between baseline and post-cycle scores was strong (r=0.88, p<0.001). The highest symptom burden was noted in pain, odynophagia, and eating restriction domains. Conclusion: Early improvements in symptom-specific HRQoL were observed after two chemotherapy cycles, especially among younger and adjuvant-therapy patients. Routine early-cycle HRQoL monitoring using the EORTC QLQ-OES25 may help assess treatment tolerance and patient adaptation. Larger multicenter studies with longer follow-up are warranted.