Canhua Xiao1, Qiang Zhang2, Phuc Felix Nguyen-Tân3, Marcie List4, Randal S Weber5, K Kian Ang5, David Rosenthal5, Edith J Filion3, Harold Kim6, Craig Silverman7, Adam Raben8, Thomas Galloway9, Andre Fortin10, Elizabeth Gore11, Eric Winquist12, Christopher U Jones13, William Robinson14, David Raben15, Quynh-Thu Le16, Deborah Bruner17. 1. Emory University, Atlanta, Georgia. Electronic address: canhua.xiao@emory.edu. 2. NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania. 3. Centre Hospitalier de l'Université de Montréal-Notre Dame, Montréal, Quebec, Canada. 4. The University of Chicago, Chicago, Illinois. 5. University of Texas-MD Anderson Cancer Center, Houston, Texas. 6. Wayne State University, Karmanos Cancer Center, Detroit, Michigan. 7. James Graham Brown Cancer Center-University of Louisville, Louisville, Kentucky. 8. Christiana Care Health Services, Inc, CCOP, Newark, Delaware. 9. Fox Chase Cancer Center, Philadelphia, Pennsylvania. 10. L Hotel-Dieu de Quebec, Québec City, Quebec, Canada. 11. Medical College of Wisconsin, Milwaukee, Wisconsin. 12. London Regional Cancer Program, London, Ontario, Canada. 13. Sutter General Hospital, Formerly Radiological Associates of Sacramento, Sacramento, California. 14. Tulane University Medical Center, New Orleans, Louisiana. 15. University of Colorado, Denver, Colorado. 16. Stanford University Medical Center, Stanford, California. 17. Emory University, Atlanta, Georgia.
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.
RCT Entities:
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.
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