Patient- and Clinician-Reported Outcomes in Human Papillomavirus-Associated Tonsillar Carcinoma Treated With Unilateral and Bilateral Intensity Modulated Radiation Therapy-A Substudy From TROG 12.01

McDowell, L; Rischin, D; King, M; Kenny, L; Porceddu, S; Wratten, C; Macann, A; Jackson, JE; Bressel, M; Fua, T; Lin, C; Liu, C; Corry, J

Author(s): McDowell, L; Rischin, D; King, M; Kenny, L; Porceddu, S; Wratten, C; Macann, A; Jackson, JE; Bressel, M; Fua, T; Lin, C; Liu, C; Corry, J;
Details: Publication Year 2023-01-01,Volume 115,Issue #1,Page 174-188
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Publication Type: Research article
Abstract: PURPOSE: The aim of this TROG 12.01 substudy was to report longitudinal variations in patient- (PRO) and clinician-reported outcomes based on receipt of unilateral (URT) or bilateral radiation therapy (BRT). METHODS AND MATERIALS: Patients with lateralized T1-2 N1-2b human papillomavirus-associated tonsillar carcinoma (AJCC7) enrolled on TROG 12.01 were eligible. The primary endpoint was patient-reported radiation symptom severity score (MDASI-RSS) at 2 years, a composite of 9 MDASI-Head and Neck (HN) symptom items. Secondary endpoints included patient-reported symptom burden and interference (MDASI-HN), quality of life (FACT-HN), emotional distress (HADS), return to work (RTW), clinician-reported performance status scale (PSS-HN), and late adverse events (CTCAE). Mean MDASI-RSS, symptom severity (MDASI-SS), symptom interference (MDASI-SI) and selected single items were compared 1 week, 3 months, and 2 years post-RT. RESULTS: Seventy-four patients were eligible for analysis (26 URT, 48 BRT). Median follow-up was 3.7 years (1.8-5.2 years). Sociodemographic, staging, and treatment variables were mostly balanced, with larger primaries observed in the BRT group. Four regional failures were reported (3 URT, 1 BRT), including one isolated contralateral regional failure in the URT cohort. Mean MDASI-RSS scores did not differ at 2 years (URT vs BRT, 1.1 vs 1.3; difference 0.1 [95% CI: -0.7 to 0.9], P = .75) or at any other time points for the MDASI-RSS, MDASI-SS, and MDASI-SI scores, except for worse MDASI-SI 1 week after treatment in the BRT group (4.7 vs 5.6). Fatigue (6.6 vs 5.4) at 1 week and dry mouth (3.5 vs 2.0) at 2 years were also worse in the BRT group. FACT-HN, HADS, RTW, PSS-HN, and CTCAE results were similar across the follow-up period. CONCLUSIONS: In this favorable-risk cohort, treatment laterality resulted in fewer differences than anticipated in patient-reported or clinician-reported outcomes. Two years after treatment patients treated with BRT reported significantly worse dry mouth. Longer follow-up is needed to determine the impact of treatment laterality on late effects.
Publisher: Elsevier
Keywords: Humans; Quality of Life; Human Papillomavirus Viruses; *Tonsillar Neoplasms/radiotherapy; *Xerostomia; Patient Reported Outcome Measures; *Carcinoma
Department(s): Radiation Oncology; Biostatistics and Clinical Trials; Medical Oncology
PubMed ID: 35961477
Publisher's Version: https://doi.org/10.1016/j.ijrobp.2022.08.006
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-06-06 06:44:05

Last Modified: 2024-07-09 05:59:11