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Quality of Life and Performance Status From a Substudy Conducted Within a Prospective Phase 3 Randomized Trial of Concurrent Standard Radiation Versus Accelerated Radiation Plus Cisplatin for Locally Advanced Head and Neck Carcinoma: NRG Oncology RTOG 0129. Int J Radiat Oncol Biol Phys 2017 Mar 15;97(4):667-677

Date

10/12/2016

Pubmed ID

27727063

Pubmed Central ID

PMC5266672

DOI

10.1016/j.ijrobp.2016.07.020

Scopus ID

2-s2.0-84992206095 (requires institutional sign-in at Scopus site)   32 Citations

Abstract

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 MATERIALS: Eligible patients were randomized into either an accelerated-fractionation arm or a standard-fractionation arm, and completed the Performance Status Scale for the Head and Neck (PSS-HN), the Head and Neck Radiotherapy Questionnaire (HNRQ), and the Spitzer Quality of Life Index (SQLI) at 8 time points from before treatment to 5 years after treatment.

RESULTS: The results from the analysis of area under the curve showed that QOL/PS was not significantly different between the 2 arms from baseline to year after treatment (P ranged from .39 to .98). The results from general linear mixed models further supported the nonsignificant treatment effects until 5 years after treatment (P=.95, .90, and .84 for PSS-HN Diet, Eating, and Speech, respectively). Before treatment and after 1 year after treatment, p16-positive oropharyngeal cancer (OPC) patients had better QOL than did p16-negative patients (P ranged from .0283 to <.0001 for all questionnaires). However, QOL/PS decreased more significantly from pretreatment to the last 2 weeks of treatment in the p16-positive group than in the p16-negative group (P ranged from .0002 to <.0001). Pretreatment QOL/PS was a significant independent predictor of overall survival, progression-free survival, and local-regional failure but not of distant metastasis (P ranged from .0063 to <.0001).

CONCLUSIONS: The results indicated that patients in both arms may have experienced similar QOL/PS. p16-positive patients had better QOL/PS at baseline and after 1 year of follow-up. Patients presenting with better baseline QOL/PS scores had better survival.

Author List

Xiao C, Zhang Q, Nguyen-Tân PF, List M, Weber RS, Ang KK, Rosenthal D, Filion EJ, Kim H, Silverman C, Raben A, Galloway T, Fortin A, Gore E, Winquist E, Jones CU, Robinson W, Raben D, Le QT, Bruner D

Author

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

Adult
Aged
Aged, 80 and over
Antineoplastic Agents
Chemoradiotherapy
Cisplatin
Female
Head and Neck Neoplasms
Humans
Longitudinal Studies
Male
Middle Aged
Neoplasm Recurrence, Local
Prevalence
Quality of Life
Risk Factors
Survival Rate
Treatment Outcome
United States