Quality-adjusted survival in women with gynecologic malignancies receiving IMRT after surgery: A Ppatient Rreported Ooutcome study of NRG oncology's RTOG 1203

Andre Konski¹, Snehal Deshmukh², Ann H Klopp³, Anamaria R Yeung⁴, Shannon N Westin³, J Spencer Thompson⁵, Desiree E Doncals⁶, Guilherme H C Cantuaria⁷, David P D'Souza⁸, Amy Chang⁹, Vijayananda Kundapur¹⁰, Dasarahally S Mohan¹¹, Michael L Haas¹², Yong Bae Kim¹³, Catherine L Ferguson¹⁴, Stephanie L Pugh², Lisa A Kachnic¹⁵, Deborah W Bruner¹⁶

Affiliations

¹ Department of Radiation Oncology, University of Pennsylvania, Senior Fellow Leonard Davis Institute of Health Economics, University of Pennsylvania, The Chester County Hospital, 701 E. Marshall Ave, West Chester, PA 19380, USA; Senior Fellow, Leonard Davis Institute for Health Economics, University of Pennsylvania, Department of Radiation Oncology, University of Pennsylvania, The Chester County Hospital, 701 E. Marshall Ave, West Chester, PA 19380, USA. Electronic address: andre.konski@uphs.upenn.edu.
² American College of Radiology, NRG Statistical and Data Management Center, NRG Oncology, 50 South 16th Street, Suite 2800, Philadelphia, PA 19102, USA.
³ Department of Radiation Oncology, MD Anderson Cancer Center, Division of Radiation Oncology, 1515 Holcombe Boulevard, The University of Texas, Unit 1422, Houston, TX 77030, USA.
⁴ Department of Radiation Oncology, University of Florida, 2000 Southwest Archer Road PO Box 100385 Gainesville, FL 32610, USA.
⁵ Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, 800 Northeast Tenth Street, Fifth Floor, Oklahoma City, OK 73104, USA.
⁶ SUMMA Akron City Hospital/ Cooper Cancer Center, 161 North Forge Street, Suite G90, Akron, OH 44304, USA.
⁷ Northside Hospital, University Gynecologic Oncology 960 Johnson Ferry Road Northeast Suite 130 Atlanta, GA 30342, USA.
⁸ London Regional Cancer Program, London Health Sciences Centre, 339 Windermere Road, P.O. Box 5339, Stn Z, London, Ontario N6A 5A5, Canada.
⁹ Pamela Youde Nethersole Eastern Hospital, Main Block, Lok Man Rd, Chai Wan, Hong Kong.
¹⁰ Saskatoon Cancer Center, University of Saskatchewan, 20 Campus Drive, Saskatoon, SK S7N 4H4, Canada.
¹¹ Kaiser Permanente Cancer Treatment Center, Department of Radiation Oncology, 220 Oyster Point Boulevard South, San Francisco, CA 94080, USA.
¹² Department of Radiation Oncology, McGlinn Cancer Institute Reading, Reading Hospital Radiation Oncology Department, 420 South Fifth Avenue West Reading, PA 19611, USA.
¹³ Yonsei University Health System, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
¹⁴ Georgia Regents University, Augusta University Medical Center, Section of Hematology and Oncology, 1120 15th Street, BAA-5407 Augusta, GA 30912, USA.
¹⁵ Department of Radiation Oncology, Columbia University, Herbert Irving Comprehensive Cancer Center, NYP/Columbia University Medical Center, Department of Radiation Oncology, 622 West 168th Street, New York, NY 10032, USA.
¹⁶ Emory University Hospital/Winship Cancer Institute, 1599, Clifton Road, Northeast, Fourth Floor, Atlanta, GA 30322, USA.

PMID: 37393743
PMCID: PMC10527270
DOI: 10.1016/j.ygyno.2023.05.074

Quality-adjusted survival in women with gynecologic malignancies receiving IMRT after surgery: A Ppatient Rreported Ooutcome study of NRG oncology's RTOG 1203

Andre Konski et al. Gynecol Oncol. 2023 Aug.

. 2023 Aug:175:176-181.

doi: 10.1016/j.ygyno.2023.05.074. Epub 2023 Jun 30.

Authors

Affiliations

¹ Department of Radiation Oncology, University of Pennsylvania, Senior Fellow Leonard Davis Institute of Health Economics, University of Pennsylvania, The Chester County Hospital, 701 E. Marshall Ave, West Chester, PA 19380, USA; Senior Fellow, Leonard Davis Institute for Health Economics, University of Pennsylvania, Department of Radiation Oncology, University of Pennsylvania, The Chester County Hospital, 701 E. Marshall Ave, West Chester, PA 19380, USA. Electronic address: andre.konski@uphs.upenn.edu.
² American College of Radiology, NRG Statistical and Data Management Center, NRG Oncology, 50 South 16th Street, Suite 2800, Philadelphia, PA 19102, USA.
³ Department of Radiation Oncology, MD Anderson Cancer Center, Division of Radiation Oncology, 1515 Holcombe Boulevard, The University of Texas, Unit 1422, Houston, TX 77030, USA.
⁴ Department of Radiation Oncology, University of Florida, 2000 Southwest Archer Road PO Box 100385 Gainesville, FL 32610, USA.
⁵ Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, 800 Northeast Tenth Street, Fifth Floor, Oklahoma City, OK 73104, USA.
⁶ SUMMA Akron City Hospital/ Cooper Cancer Center, 161 North Forge Street, Suite G90, Akron, OH 44304, USA.
⁷ Northside Hospital, University Gynecologic Oncology 960 Johnson Ferry Road Northeast Suite 130 Atlanta, GA 30342, USA.
⁸ London Regional Cancer Program, London Health Sciences Centre, 339 Windermere Road, P.O. Box 5339, Stn Z, London, Ontario N6A 5A5, Canada.
⁹ Pamela Youde Nethersole Eastern Hospital, Main Block, Lok Man Rd, Chai Wan, Hong Kong.
¹⁰ Saskatoon Cancer Center, University of Saskatchewan, 20 Campus Drive, Saskatoon, SK S7N 4H4, Canada.
¹¹ Kaiser Permanente Cancer Treatment Center, Department of Radiation Oncology, 220 Oyster Point Boulevard South, San Francisco, CA 94080, USA.
¹² Department of Radiation Oncology, McGlinn Cancer Institute Reading, Reading Hospital Radiation Oncology Department, 420 South Fifth Avenue West Reading, PA 19611, USA.
¹³ Yonsei University Health System, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
¹⁴ Georgia Regents University, Augusta University Medical Center, Section of Hematology and Oncology, 1120 15th Street, BAA-5407 Augusta, GA 30912, USA.
¹⁵ Department of Radiation Oncology, Columbia University, Herbert Irving Comprehensive Cancer Center, NYP/Columbia University Medical Center, Department of Radiation Oncology, 622 West 168th Street, New York, NY 10032, USA.
¹⁶ Emory University Hospital/Winship Cancer Institute, 1599, Clifton Road, Northeast, Fourth Floor, Atlanta, GA 30322, USA.

PMID: 37393743
PMCID: PMC10527270
DOI: 10.1016/j.ygyno.2023.05.074

Abstract

Introduction: NRG/RTOG 1203 compared 3-D conformal radiotherapy (3D CRT) to intensity-modulated radiotherapy (IMRT) in patients with endometrial or cervical cancer requiring post-operative radiotherapy after hysterectomy. The purpose of this study was to report the first quality-adjusted survival analysis comparing the two treatments.

Methods: NRG/RTOG 1203 randomized patients having undergone hysterectomy to either 3DCRT or IMRT. Stratification factors included RT dose, chemotherapy, and disease site. The EQ-5D, both index and visual analog scale (VAS), were obtained at baseline, 5 weeks after the start of RT, 4-6 weeks post RT and 1 and 3-years post RT. EQ-5D index and VAS scores along with quality-adjusted survival (QAS) were compared between treatment arms using the t-test at a two-sided significance level of 0.05.

Results: NRG/RTOG 1203 enrolled 289 patients of which 236 consented to participate in the patient reported outcome (PRO) assessments. QAS was higher in women treated with IMRT, 1374 vs 1333 days (p = 0.5) compared to patients treated with 3DCRT, but this difference was not statistically different. Patients treated with IMRT had less of a decline in VAS score 5 weeks post RT, -5.04, compared to patients treated with 3DCRT, -7.48, although not statistically significant (p = 0.38).

Conclusion: This is the first report of the use of the EQ-5D comparing two radiotherapy techniques in the treatment of gynecologic malignancies after surgery. While there were no significant differences in QAS and VAS scores between patients who received IMRT vs. 3DCRT, RTOG 1203 was not powered to show statistical differences in these secondary endpoints.

Keywords: Cervical cancer; Endometrial cancer; Intensity modulated radiotherapy (IMRT); Patient reported outcomes; Utilities.

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Figures

**Figure 2:**
Mean index and Visual Analog Scale (VAS) scores across time.

See this image and copyright information in PMC

References

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Quality-adjusted survival in women with gynecologic malignancies receiving IMRT after surgery: A Ppatient Rreported Ooutcome study of NRG oncology's RTOG 1203

Affiliations

Quality-adjusted survival in women with gynecologic malignancies receiving IMRT after surgery: A Ppatient Rreported Ooutcome study of NRG oncology's RTOG 1203

Authors

Affiliations

Abstract

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References

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MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Research Materials