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  • [J Clin Oncol.] Patient-Reported Toxicity During Pelvic Intensity-Modulated Radiation Therapy: NRG Oncology-RTOG 1203.

    The University of Texas MD Anderson Cancer Center / Ann H. Klopp*

  • 출처
    J Clin Oncol.
  • 등재일
    2018 Aug 20
  • 저널이슈번호
    36(24):2538-2544. doi: 10.1200/JCO.2017.77.4273. Epub 2018 Jul 10.
  • 내용

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    Abstract
    Purpose NRG Oncology/RTOG 1203 was designed to compare patient-reported acute toxicity and health-related quality of life during treatment with standard pelvic radiation or intensity-modulated radiation therapy (IMRT) in women with cervical and endometrial cancer. Methods Patients were randomly assigned to standard four-field radiation therapy (RT) or IMRT radiation treatment. The primary end point was change in patient-reported acute GI toxicity from baseline to the end of RT, measured with the bowel domain of the Expanded Prostate Cancer Index Composite (EPIC). Secondary end points included change in patient-reported urinary toxicity, change in GI toxicity measured with the Patient-Reported Outcome Common Terminology Criteria for Adverse Events, and quality of life measured with the Trial Outcome Index. Results From 2012 to 2015, 289 patients were enrolled, of whom 278 were eligible. Between baseline and end of RT, the mean EPIC bowel score declined 23.6 points in the standard RT group and 18.6 points in the IMRT group ( P = .048), the mean EPIC urinary score declined 10.4 points in the standard RT group and 5.6 points in the IMRT group ( P = .03), and the mean Trial Outcome Index score declined 12.8 points in the standard RT group and 8.8 points in the IMRT group ( P = .06). At the end of RT, 51.9% of women who received standard RT and 33.7% who received IMRT reported frequent or almost constant diarrhea ( P = .01), and more patients who received standard RT were taking antidiarrheal medications four or more times daily (20.4% v 7.8%; P = .04). Conclusion Pelvic IMRT was associated with significantly less GI and urinary toxicity than standard RT from the patient's perspective.

     


    Author information

    Klopp AH1, Yeung AR1, Deshmukh S1, Gil KM1, Wenzel L1, Westin SN1, Gifford K1, Gaffney DK1, Small W Jr1, Thompson S1, Doncals DE1, Cantuaria GHC1, Yaremko BP1, Chang A1, Kundapur V1, Mohan DS1, Haas ML1, Kim YB1, Ferguson CL1, Pugh SL1, Kachnic LA1, Bruner DW1.
    1
    Ann H. Klopp, Shannon N. Westin, and Kent Gifford, MD Anderson Cancer Center, Houston, TX; Anamaria R. Yeung, University of Florida, Gainsville, FL; Snehal Deshmukh and Stephanie L. Pugh, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Karen M. Gil, Summa Health System; Desiree E. Doncals, Summa Akron City Hospital, Akron, OH; Lari Wenzel, University of California Medical Center at Irvine, Irvine, CA; David K. Gaffney, University of Utah, Salt Lake City, UT; William Small Jr, Loyola University Medical Center, Maywood, IL; Spencer Thompson, University of Oklahoma Health Sciences Center, Oklahoma City, OK; Guilherme H.C. Cantuaria, Northside Hospital, Atlanta, GA; Brian P. Yaremko, London Regional Cancer Program, London, Ontario; Vijayananda Kundapur, Saskatoon Cancer Centre, Saskatoon, Saskatchewan, Canada; Amy Chang, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong; Dasarahally S. Mohan, Kaiser Permanente Cancer Treatment Center, South San Francisco, CA; Michael L. Haas, Reading Hospital, West Reading, PA; Yong Bae Kim, Yonsei University Health System-Severance Hospital, Seoul, South Korea; Catherine L. Ferguson, Georgia Regents University, Augusta; Deborah W. Bruner, Emory University, Atlanta, GA; and Lisa A. Kachnic, Vanderbilt University, Nashville, TN.

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