Quality of life and performance status from a sub-study conducted within a prospective phase III randomized trial of concurrent standard radiation vs. accelerated radiation plus cisplatin for locally advanced head and neck carcinoma: NRG Oncology RTOG 0129

Publication date: Available online 25 July 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Canhua Xiao, Qiang Zhang, Phuc Felix Nguyen-Tân, Marcie List, Randal S. Weber, K. Kian Ang, David Rosenthal, Edith J. Filion, Harold Kim, Craig Silverman, Adam Raben, Thomas Galloway, Andre Fortin, Elizabeth Gore, Eric Winquist, Christopher U. Jones, William Robinson, David Raben, Quynh-Thu Le, Deborah Bruner
Purpose/Objective(s)To analyze quality of life (QOL) and performance status (PS) for head and neck cancer (HNC) patients treated on NRG Oncology RTOG 0129 by treatment (secondary outcome) and p16 status, and to examine the association between QOL/PS and survival.Methods and MaterialsEligible patients were randomized into either accelerated-fractionation arm or standard-fractionation arm, and completed the Performance Status Scale for the HN (PSS-HN), the Head and Neck Radiotherapy Questionnaire (HNRQ), and the Spitzer Quality of Life Index (SQLI) at 8 time points from pre-treatment to 5-years post-treatment.ResultsResults from the analysis of area under the curve showed that QOL/PS was not significantly different between the two arms from baseline to one-year post-treatment (p ranged from 0.39 to 0.98).: Results from general linear mixed models further supported the non-significant treatment effects until 5 years post-treatment (p=0.95, 0.90, and 0.84 for PSS-HN Diet, Eating, and Speech, respectively).At pre-treatment and after one year post-treatment, p16-positive oropharyngeal cancer (OPC) patients had better QOL than p16-negative patients (p ranged from 0.0283 to <0.0001 for all questionnaires). However, QOL/PS decreased more significantly from pre-treatment to the last 2 weeks of treatment in the p16-positive group than the p16-negative group (p ranged from 0.0002 to <0.0001).Pre-treatment QOL/PS was a significant independent predictor of overall, progression-free, and locoregional failure but not distant metastasis (p ranged from 0.0063 to <0.0001).ConclusionsThe results indicated patients in both arms may have experienced similar QOL/PS. p16-positive patients had better QOL/PS at baseline and after one-year follow-up. Patients presenting with better baseline QOL/PS scores had better survival.

Teaser

This large international, multi-institutional phase III trial yielded three major findings related to quality of life (QOL)/performance status (PS). First, QOL/PS was similar in both accelerated and standard radiotherapy arms. Second, p16-positive oropharyngeal cancer patients experienced better QOL/PS than p16-negative patients. Finally, pre-treatment QOL/ PS was a significant independent prognostic factor for survival in locally advanced HNC patients.


from Cancer via ola Kala on Inoreader http://ift.tt/2a9SBL2
via IFTTT