Evaluation of adverse events and health-related quality of life in patients with colorectal cancer receiving ambulatory home-based chemotherapy in Thailand.

Patients chose hospital or home treatment, and the study did not randomise them, so differences may reflect patient characteristics, support or comorbidity rather than the treatment setting. The groups were not balanced by age: hospital patients were younger (mean 57.7 years) than home patients (mean 62.2 years), and age was associated with social well-being. The study was single-centre, used a preference-based design, and the authors note selection bias cannot be ruled out. Home patients had to live near a Bangkok hospital, have an implantable port, have performance status 2 or less and no cognitive impairment, so results may not apply to more frail or distant patients. The FACT-C questionnaire may not be sensitive enough to detect small quality-of-life differences, and total quality of life did not improve despite the social well-being finding. Adverse event reporting did not separate the effects of chemotherapy regimen, recurrent disease, comorbidity and home support.

Authors declared no conflicts of interest. The article metadata lists non-U.S. government research support.

Do not conclude that home chemotherapy improves overall quality of life or is safer. Only social well-being was higher in the home group; total and other quality-of-life domains were not significantly different, and nausea, mucositis and fatigue were more frequent in the home group. Patients chose their setting, so the differences may not be caused by home care.