Faculty Collaboration Database

The effects of comorbidity and age on RTOG study enrollment in Stage III non-small cell lung cancer patients who are eligible for RTOG studies. Int J Radiat Oncol Biol Phys 2010 Dec 01;78(5):1394-9

Date

07/22/2010

Pubmed ID

20646856

DOI

10.1016/j.ijrobp.2009.09.051

Scopus ID

2-s2.0-78549246163 (requires institutional sign-in at Scopus site)   28 Citations

Abstract

PURPOSE: To determine the influence of measured comorbidity in Radiation Therapy Oncology Group (RTOG) combined modality therapy (CMT) study enrollment in Stage III non-small cell lung cancer (NSCLC).

METHODS AND MATERIALS: One hundred and seventy-one patients with a Karnofsky Performance Score ≥70 and clinical Stage III NSCLC were analyzed retrospectively for comorbidity, RTOG study eligibility, and enrollment at initial consultation. Effect of comorbidity scores (Cumulative Illness Rating Scale) were tested on patient selection for CMT, RTOG enrollment, and overall survival.

RESULTS: Comorbidity (Grade 4; p < 0.005) and use of radiation only (p ≤ 0.001) were associated with inferior survival independent of other factors. Patient selection for CMT was affected by age (≥70, p < 0.001), comorbidity (severity index [SI] > 2, p = 0.001), and weight loss (>5%, p = 0.001). Thirty-three patients (19%) were enrolled in a CMT RTOG study (Group 1). Forty-nine patients (29%) were eligible but not enrolled (Group 2), and 57 (33%) were ineligible (Group 3). The most common ineligibility reasons were weight loss (67%) and comorbidity in the exclusion criteria of the RTOG studies (63%). Group 1 patients were the youngest (p = 0.02), with the lowest comorbidity scores (p < 0.001) and SI (p < 0.001) compared with Groups 2 and 3. Group 3 patients were the oldest with the most unfavorable comorbidity profile. Comorbidity scores (SI >2; p = 0.006) and age (≥70; p = 0.05) were independent factors influencing RTOG study enrollment in patients meeting study eligibility requirements (Groups 1 and 2).

CONCLUSIONS: Comorbidity scales could be useful in stratification of patients in advanced lung cancer trials and interpretation of results particularly regarding the elderly population.

Author List

Firat S, Byhardt RW, Gore E

Authors

Selim Firat MD Professor in the Radiation Oncology department at Medical College of Wisconsin
Elizabeth M. Gore MD Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Age Factors
Aged
Carcinoma, Non-Small-Cell Lung
Combined Modality Therapy
Comorbidity
Humans
Karnofsky Performance Status
Lung Neoplasms
Neoplasm Staging
Patient Selection
Proportional Hazards Models
Radiotherapy Dosage
Retrospective Studies
Severity of Illness Index
Survival Rate
Weight Loss