The correlation between pre-treatment symptoms, acute and late toxicity and patient-reported health-related quality of life in non-small cell lung cancer patients: Results of the REQUITE study.
Association
Health-related quality of life
Non-small cell lung cancer
Patient-reported outcomes
Radiotherapy
Toxicity
Journal
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
24
05
2022
revised:
16
09
2022
accepted:
25
09
2022
pubmed:
5
10
2022
medline:
2
12
2022
entrez:
4
10
2022
Statut:
ppublish
Résumé
To investigate the association between clinician-scored toxicities and patient-reported health-related quality of life (HRQoL), in early-stage (ES-) and locally-advanced (LA-) non-small cell lung cancer (NSCLC) patients receiving loco-regional radiotherapy, included in the international real-world REQUITE study. Clinicians scored eleven radiotherapy-related toxicities (and baseline symptoms) with the Common Terminology Criteria for Adverse Events version 4. HRQoL was assessed with the European Organization for Research and Treatment of Cancer core HRQoL questionnaire (EORTC-QLQ-C30). Statistical analyses used the mixed-model method; statistical significance was set at p = 0.01. Analyses were performed for baseline and subsequent time points up to 2 years after radiotherapy and per treatment modality, radiotherapy technique and disease stage. Data of 435 patients were analysed. Pre-treatment, overall symptoms, dyspnea, chest wall pain, dysphagia and cough impacted overall HRQoL and specific domains. At subsequent time points, cough and dysphagia were overtaken by pericarditis in affecting HRQoL. Toxicities during concurrent chemo-radiotherapy and 3-dimensional radiotherapy had the most impact on HRQoL. Conversely, toxicities in sequential chemo-radiotherapy and SBRT had limited impact on patients' HRQoL. Stage impacts the correlations: LA-NSCLC patients are more adversely affected by toxicity than ES-NSCLC patients, mimicking the results of radiotherapy technique and treatment modality. Pre-treatment symptoms and acute/late toxicities variously impact HRQoL of ES- and LA-NSCLC patients undergoing different treatment approaches and radiotherapy techniques. Throughout the disease, dyspnea seems crucial in this association, highlighting the additional effect of co-existing comorbidities. Our data call for optimized radiotherapy limiting toxicities that may affect patients' HRQoL.
Sections du résumé
BACKGROUND AND PURPOSE
To investigate the association between clinician-scored toxicities and patient-reported health-related quality of life (HRQoL), in early-stage (ES-) and locally-advanced (LA-) non-small cell lung cancer (NSCLC) patients receiving loco-regional radiotherapy, included in the international real-world REQUITE study.
MATERIALS AND METHODS
Clinicians scored eleven radiotherapy-related toxicities (and baseline symptoms) with the Common Terminology Criteria for Adverse Events version 4. HRQoL was assessed with the European Organization for Research and Treatment of Cancer core HRQoL questionnaire (EORTC-QLQ-C30). Statistical analyses used the mixed-model method; statistical significance was set at p = 0.01. Analyses were performed for baseline and subsequent time points up to 2 years after radiotherapy and per treatment modality, radiotherapy technique and disease stage.
RESULTS
Data of 435 patients were analysed. Pre-treatment, overall symptoms, dyspnea, chest wall pain, dysphagia and cough impacted overall HRQoL and specific domains. At subsequent time points, cough and dysphagia were overtaken by pericarditis in affecting HRQoL. Toxicities during concurrent chemo-radiotherapy and 3-dimensional radiotherapy had the most impact on HRQoL. Conversely, toxicities in sequential chemo-radiotherapy and SBRT had limited impact on patients' HRQoL. Stage impacts the correlations: LA-NSCLC patients are more adversely affected by toxicity than ES-NSCLC patients, mimicking the results of radiotherapy technique and treatment modality.
CONCLUSION
Pre-treatment symptoms and acute/late toxicities variously impact HRQoL of ES- and LA-NSCLC patients undergoing different treatment approaches and radiotherapy techniques. Throughout the disease, dyspnea seems crucial in this association, highlighting the additional effect of co-existing comorbidities. Our data call for optimized radiotherapy limiting toxicities that may affect patients' HRQoL.
Identifiants
pubmed: 36195214
pii: S0167-8140(22)04490-5
doi: 10.1016/j.radonc.2022.09.020
pmc: PMC10404651
mid: NIHMS1895311
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
127-137Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : Cancer Research UK
ID : C147/A2524
Pays : United Kingdom
Informations de copyright
Crown Copyright © 2022. Published by Elsevier B.V. All rights reserved.
Références
Ann Am Thorac Soc. 2017 Oct;14(10):1512-1513
pubmed: 28961028
Oral Oncol. 2011 Aug;47(8):768-74
pubmed: 21683647
Onco Targets Ther. 2016 Feb 29;9:1023-8
pubmed: 27013895
Ann Surg Oncol. 2010 Jun;17(6):1471-4
pubmed: 20180029
Front Oncol. 2021 Jun 17;11:685605
pubmed: 34222010
JAMA Netw Open. 2019 Nov 1;2(11):e1915724
pubmed: 31747032
Ther Adv Med Oncol. 2011 Mar;3(2):57-71
pubmed: 21789156
J Clin Oncol. 2008 Aug 1;26(22):3770-6
pubmed: 18669465
Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S70-6
pubmed: 20171521
Cancers (Basel). 2018 Jul 03;10(7):
pubmed: 29970850
J Thorac Oncol. 2012 Jan;7(1):64-70
pubmed: 22134070
Radiother Oncol. 2014 Feb;110(2):284-90
pubmed: 24411226
Crit Rev Oncol Hematol. 2017 Nov;119:40-49
pubmed: 29065984
Chest. 2012 Apr;141(4):858-866
pubmed: 21885726
Lancet Oncol. 2020 May;21(5):723-732
pubmed: 32213338
Radiother Oncol. 2019 Sep;138:59-67
pubmed: 31146072
Ann Oncol. 2017 Jul 1;28(suppl_4):iv1-iv21
pubmed: 28881918
J Clin Oncol. 2008 Jan 10;26(2):233-41
pubmed: 18086802
Radiol Oncol. 2018 Feb 21;52(3):281-288
pubmed: 30210037
Methods Mol Med. 2005;117:3-44
pubmed: 16130230
Eur J Cancer. 2017 Sep;83:166-176
pubmed: 28738257
Int J Radiat Oncol Biol Phys. 2000 Apr 1;47(1):149-55
pubmed: 10758317
Int J Radiat Oncol Biol Phys. 2001 Nov 1;51(3):650-9
pubmed: 11597805
Radiother Oncol. 2016 Dec;121(3):414-419
pubmed: 27637858
J Hosp Palliat Nurs. 2012 Jul;14(5):341-342
pubmed: 24058283
Radiother Oncol. 2022 Mar;168:234-240
pubmed: 35121030
J Natl Cancer Inst. 1993 Mar 3;85(5):365-76
pubmed: 8433390
Int J Cancer. 2021 Apr 5;:
pubmed: 33818764
Acta Chir Belg. 2003 Aug;103(4):396-400
pubmed: 14524159
Health Econ Rev. 2013 May 16;3(1):15
pubmed: 23680096
Qual Life Res. 2004 Mar;13(2):481-8
pubmed: 15085920
Lung Cancer. 2022 Apr;166:228-241
pubmed: 35334417
Lancet Oncol. 2006 Nov;7(11):903-9
pubmed: 17081915
Br J Cancer. 2009 May 19;100(10):1558-65
pubmed: 19384297
Radiother Oncol. 2009 Jun;91(3):443-8
pubmed: 19297049
Eur J Cancer. 1994;30A(5):635-42
pubmed: 8080679
Front Oncol. 2020 Jun 05;10:790
pubmed: 32582539
Radiother Oncol. 2015 Jul;116(1):45-50
pubmed: 26002304
Radiother Oncol. 2018 Feb;126(2):191-197
pubmed: 29229506
Mayo Clin Proc. 2019 Aug;94(8):1623-1640
pubmed: 31378236
Int J Radiat Oncol Biol Phys. 2014 Nov 1;90(3):603-11
pubmed: 25052562
Radiother Oncol. 2009 Jun;91(3):353-9
pubmed: 19012981
Front Med (Lausanne). 2019 Nov 07;6:244
pubmed: 31788476
Int J Radiat Oncol Biol Phys. 2012 Mar 1;82(3):1065-74
pubmed: 21605943