BACKGROUND:Longitudinal quality of life (QoL) was compared for patients with esophageal cancer receiving definitive chemoradiotherapy (CRT) withconventional-dose (CD) vs. high-dose (HD) radiotherapy as used in the RTOG phase III 94-05 trial (Intergroup 0123). METHODS:Between June 12, 1995, and July 1, 1999, 236 patients with cT1-4NxM0 esophageal cancer were randomized to CD CRT (50.4 Gy and concurrent 5-fluorouracil and cisplatin) vs. HD CRT (64.8 Gy and the same chemotherapy). QoL was assessed using the Functional Assessment of Cancer Therapy, Head & Neck (version 2) at baseline, after CRT, at 8 months from the start of CRT, and at 1 year. RESULTS: Of 218 eligible patients, 166 participated in pretreatment QoL assessments (82 HD, 84 CD). Patients with ≥10% weight loss and Karnofsky Performance Status 60-80 were less likely to participate (P = .02 and P = .002, respectively). Pretreatment characteristics for participating patients were similar in both arms. At CRT completion, 96 patients completed QoL (46 HD, 50 CD) assessment. Total mean QoL was significantly lower in the HD arm (P = .02) and remained lower at 8 and 12 months after the start of CRT, but these values did not reach statistical significance. Change in mean QoL from baseline to each of the three subsequent assessment time points did not differ significantly between the two treatment arms. CONCLUSIONS: For patients treated with definitive CRT for esophageal cancer, radiation dose escalation to 64.8 Gy does not significantly improve QoL. These results provide additional evidence that radiotherapy to 50.4 Gy should remain the standard of care.
RCT Entities:
BACKGROUND: Longitudinal quality of life (QoL) was compared for patients with esophageal cancer receiving definitive chemoradiotherapy (CRT) with conventional-dose (CD) vs. high-dose (HD) radiotherapy as used in the RTOG phase III 94-05 trial (Intergroup 0123). METHODS: Between June 12, 1995, and July 1, 1999, 236 patients with cT1-4NxM0 esophageal cancer were randomized to CD CRT (50.4 Gy and concurrent 5-fluorouracil and cisplatin) vs. HD CRT (64.8 Gy and the same chemotherapy). QoL was assessed using the Functional Assessment of Cancer Therapy, Head & Neck (version 2) at baseline, after CRT, at 8 months from the start of CRT, and at 1 year. RESULTS: Of 218 eligible patients, 166 participated in pretreatment QoL assessments (82 HD, 84 CD). Patients with ≥10% weight loss and Karnofsky Performance Status 60-80 were less likely to participate (P = .02 and P = .002, respectively). Pretreatment characteristics for participating patients were similar in both arms. At CRT completion, 96 patients completed QoL (46 HD, 50 CD) assessment. Total mean QoL was significantly lower in the HD arm (P = .02) and remained lower at 8 and 12 months after the start of CRT, but these values did not reach statistical significance. Change in mean QoL from baseline to each of the three subsequent assessment time points did not differ significantly between the two treatment arms. CONCLUSIONS: For patients treated with definitive CRT for esophageal cancer, radiation dose escalation to 64.8 Gy does not significantly improve QoL. These results provide additional evidence that radiotherapy to 50.4 Gy should remain the standard of care.
Authors: N K Aaronson; B E Meyerowitz; M Bard; J R Bloom; F I Fawzy; M Feldstein; D Fink; J C Holland; J E Johnson; J T Lowman Journal: Cancer Date: 1991-02-01 Impact factor: 6.860
Authors: J F Bosset; M Gignoux; J P Triboulet; E Tiret; G Mantion; D Elias; P Lozach; J C Ollier; J J Pavy; M Mercier; T Sahmoud Journal: N Engl J Med Date: 1997-07-17 Impact factor: 91.245
Authors: T Conroy; P L Etienne; A Adenis; M Ducreux; B Paillot; J Oliveira; J F Seitz; E Francois; E Van Cutsem; D J T Wagener; F Kohser; S Daamen; M Praet; T Gorlia; B Baron; J Wils Journal: Ann Oncol Date: 2002-05 Impact factor: 32.976
Authors: Nils H Nicolay; Johanna Rademacher; Jan Oelmann-Avendano; Jürgen Debus; Peter E Huber; Katja Lindel Journal: Strahlenther Onkol Date: 2016-05-31 Impact factor: 3.621
Authors: Mickey S Ising; Katy Marino; Jaimin R Trivedi; Adam A Rojan; Neal E Dunlap; Victor van Berkel; Matthew P Fox Journal: J Gastrointest Surg Date: 2019-02-20 Impact factor: 3.452
Authors: Marc Jacobs; Rhiannon C Macefield; Jane M Blazeby; Ida J Korfage; Mark I van Berge Henegouwen; Hanneke C J M de Haes; Ellen M Smets; Mirjam A G Sprangers Journal: Qual Life Res Date: 2012-10-20 Impact factor: 4.147
Authors: Sweet Ping Ng; Jennifer Tan; Glen Osbourne; Luke Williams; Mathias A B Bressel; Rodney J Hicks; Eddie W F Lau; Julie Chu; Samuel Y K Ngan; Trevor Leong Journal: Clin Transl Radiat Oncol Date: 2017-03-07
Authors: Thomas J Fitzgerald; Maryann Bishop-Jodoin; Walter R Bosch; Walter J Curran; David S Followill; James M Galvin; Richard Hanusik; Steven R King; Michael V Knopp; Fran Laurie; Elizabeth O'Meara; Jeff M Michalski; Joel H Saltz; Mitchell D Schnall; Lawrence Schwartz; Kenneth Ulin; Ying Xiao; Marcia Urie Journal: Front Oncol Date: 2013-03-15 Impact factor: 6.244
Authors: Falk Roeder; Nils H Nicolay; Tam Nguyen; Ladan Saleh-Ebrahimi; Vasilis Askoxylakis; Tilman Bostel; Felix Zwicker; Juergen Debus; Carmen Timke; Peter E Huber Journal: Radiat Oncol Date: 2014-08-29 Impact factor: 3.481