A Comparison of Patient-Reported Health-Related Quality of Life During Proton Versus Photon Chemoradiation Therapy for Esophageal Cancer

Aurelie Garant, Thomas J. Whitaker, Grant M. Spears, David M. Routman, William S. Harmsen, Tyler J. Wilhite, Jonathan B. Ashman, Terence T. Sio, William G. Rule, Michelle A. Neben Wittich, James A. Martenson, Erik J. Tryggestad, Harry H Yoon, Shanda Blackmon, Kenneth W. Merrell, Michael Haddock, Christopher Hallemeier

Research output: Contribution to journalArticle

Abstract

Purpose: The purpose of this study was to compare Functional Assessment of Cancer Therapy-Esophagus (FACT-E) questionnaire changes during proton (PRT) or photon (XRT) chemoradiation therapy (CRT) for esophageal cancer (EC). Methods and Materials: We reviewed patients enrolled in a prospective registry who received preoperative or definitive CRT for EC. Patients completed the FACT-E before CRT and during the last week of CRT. Analysis of variance testing was used to assess associations between patient and treatment characteristics and FACT-E score changes. Results: One hundred twenty-five patients completed a baseline and posttreatment FACT-E; 63 received XRT and 62 received PRT. The mean age was 65 years; the PRT group was older (68 vs 64 years, P = .0063). The following characteristics were similar between cohorts: 83% male, 78% adenocarcinoma, and 89% stage II-III. The radiation therapy prescription dose was higher in the PRT group (≥50 Gy in 94% vs 67%, P < .0001), whereas the median clinical target volume was smaller in the PRT group (553 vs 668 cm3, P = .013). Most (96%) received concurrent weekly carboplatin-paclitaxel. The mean FACT-E score was 136.3 (standard deviation [SD] 21.0) at baseline and 119.6 (SD 24.8) post-CRT, with mean change of –16.7 (SD 19.8). Baseline scores were comparable between XRT and PRT groups (135.9 vs 136.7, P = .82). On univariate and multivariate analyses, less mean decline in FACT-E score was observed for PRT versus XRT (–12.7 vs –20.6, P = .026) and for trimodality versus definitive therapy (–13.0 vs –22.5, P = .008). Conclusions: For patients receiving CRT for EC, PRT was associated with less decline in FACT-E scores compared with XRT.

Original languageEnglish (US)
JournalPractical Radiation Oncology
DOIs
StateAccepted/In press - Jan 1 2019

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Esophageal Neoplasms
Photons
Protons
Quality of Life
Therapeutics
Carboplatin
Paclitaxel
Prescriptions
Registries
Analysis of Variance
Adenocarcinoma
Radiotherapy
Multivariate Analysis

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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A Comparison of Patient-Reported Health-Related Quality of Life During Proton Versus Photon Chemoradiation Therapy for Esophageal Cancer. / Garant, Aurelie; Whitaker, Thomas J.; Spears, Grant M.; Routman, David M.; Harmsen, William S.; Wilhite, Tyler J.; Ashman, Jonathan B.; Sio, Terence T.; Rule, William G.; Neben Wittich, Michelle A.; Martenson, James A.; Tryggestad, Erik J.; Yoon, Harry H; Blackmon, Shanda; Merrell, Kenneth W.; Haddock, Michael; Hallemeier, Christopher.

In: Practical Radiation Oncology, 01.01.2019.

Research output: Contribution to journalArticle

Garant, A, Whitaker, TJ, Spears, GM, Routman, DM, Harmsen, WS, Wilhite, TJ, Ashman, JB, Sio, TT, Rule, WG, Neben Wittich, MA, Martenson, JA, Tryggestad, EJ, Yoon, HH, Blackmon, S, Merrell, KW, Haddock, M & Hallemeier, C 2019, 'A Comparison of Patient-Reported Health-Related Quality of Life During Proton Versus Photon Chemoradiation Therapy for Esophageal Cancer', Practical Radiation Oncology. https://doi.org/10.1016/j.prro.2019.07.003
Garant, Aurelie ; Whitaker, Thomas J. ; Spears, Grant M. ; Routman, David M. ; Harmsen, William S. ; Wilhite, Tyler J. ; Ashman, Jonathan B. ; Sio, Terence T. ; Rule, William G. ; Neben Wittich, Michelle A. ; Martenson, James A. ; Tryggestad, Erik J. ; Yoon, Harry H ; Blackmon, Shanda ; Merrell, Kenneth W. ; Haddock, Michael ; Hallemeier, Christopher. / A Comparison of Patient-Reported Health-Related Quality of Life During Proton Versus Photon Chemoradiation Therapy for Esophageal Cancer. In: Practical Radiation Oncology. 2019.
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abstract = "Purpose: The purpose of this study was to compare Functional Assessment of Cancer Therapy-Esophagus (FACT-E) questionnaire changes during proton (PRT) or photon (XRT) chemoradiation therapy (CRT) for esophageal cancer (EC). Methods and Materials: We reviewed patients enrolled in a prospective registry who received preoperative or definitive CRT for EC. Patients completed the FACT-E before CRT and during the last week of CRT. Analysis of variance testing was used to assess associations between patient and treatment characteristics and FACT-E score changes. Results: One hundred twenty-five patients completed a baseline and posttreatment FACT-E; 63 received XRT and 62 received PRT. The mean age was 65 years; the PRT group was older (68 vs 64 years, P = .0063). The following characteristics were similar between cohorts: 83{\%} male, 78{\%} adenocarcinoma, and 89{\%} stage II-III. The radiation therapy prescription dose was higher in the PRT group (≥50 Gy in 94{\%} vs 67{\%}, P < .0001), whereas the median clinical target volume was smaller in the PRT group (553 vs 668 cm3, P = .013). Most (96{\%}) received concurrent weekly carboplatin-paclitaxel. The mean FACT-E score was 136.3 (standard deviation [SD] 21.0) at baseline and 119.6 (SD 24.8) post-CRT, with mean change of –16.7 (SD 19.8). Baseline scores were comparable between XRT and PRT groups (135.9 vs 136.7, P = .82). On univariate and multivariate analyses, less mean decline in FACT-E score was observed for PRT versus XRT (–12.7 vs –20.6, P = .026) and for trimodality versus definitive therapy (–13.0 vs –22.5, P = .008). Conclusions: For patients receiving CRT for EC, PRT was associated with less decline in FACT-E scores compared with XRT.",
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T1 - A Comparison of Patient-Reported Health-Related Quality of Life During Proton Versus Photon Chemoradiation Therapy for Esophageal Cancer

AU - Garant, Aurelie

AU - Whitaker, Thomas J.

AU - Spears, Grant M.

AU - Routman, David M.

AU - Harmsen, William S.

AU - Wilhite, Tyler J.

AU - Ashman, Jonathan B.

AU - Sio, Terence T.

AU - Rule, William G.

AU - Neben Wittich, Michelle A.

AU - Martenson, James A.

AU - Tryggestad, Erik J.

AU - Yoon, Harry H

AU - Blackmon, Shanda

AU - Merrell, Kenneth W.

AU - Haddock, Michael

AU - Hallemeier, Christopher

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: The purpose of this study was to compare Functional Assessment of Cancer Therapy-Esophagus (FACT-E) questionnaire changes during proton (PRT) or photon (XRT) chemoradiation therapy (CRT) for esophageal cancer (EC). Methods and Materials: We reviewed patients enrolled in a prospective registry who received preoperative or definitive CRT for EC. Patients completed the FACT-E before CRT and during the last week of CRT. Analysis of variance testing was used to assess associations between patient and treatment characteristics and FACT-E score changes. Results: One hundred twenty-five patients completed a baseline and posttreatment FACT-E; 63 received XRT and 62 received PRT. The mean age was 65 years; the PRT group was older (68 vs 64 years, P = .0063). The following characteristics were similar between cohorts: 83% male, 78% adenocarcinoma, and 89% stage II-III. The radiation therapy prescription dose was higher in the PRT group (≥50 Gy in 94% vs 67%, P < .0001), whereas the median clinical target volume was smaller in the PRT group (553 vs 668 cm3, P = .013). Most (96%) received concurrent weekly carboplatin-paclitaxel. The mean FACT-E score was 136.3 (standard deviation [SD] 21.0) at baseline and 119.6 (SD 24.8) post-CRT, with mean change of –16.7 (SD 19.8). Baseline scores were comparable between XRT and PRT groups (135.9 vs 136.7, P = .82). On univariate and multivariate analyses, less mean decline in FACT-E score was observed for PRT versus XRT (–12.7 vs –20.6, P = .026) and for trimodality versus definitive therapy (–13.0 vs –22.5, P = .008). Conclusions: For patients receiving CRT for EC, PRT was associated with less decline in FACT-E scores compared with XRT.

AB - Purpose: The purpose of this study was to compare Functional Assessment of Cancer Therapy-Esophagus (FACT-E) questionnaire changes during proton (PRT) or photon (XRT) chemoradiation therapy (CRT) for esophageal cancer (EC). Methods and Materials: We reviewed patients enrolled in a prospective registry who received preoperative or definitive CRT for EC. Patients completed the FACT-E before CRT and during the last week of CRT. Analysis of variance testing was used to assess associations between patient and treatment characteristics and FACT-E score changes. Results: One hundred twenty-five patients completed a baseline and posttreatment FACT-E; 63 received XRT and 62 received PRT. The mean age was 65 years; the PRT group was older (68 vs 64 years, P = .0063). The following characteristics were similar between cohorts: 83% male, 78% adenocarcinoma, and 89% stage II-III. The radiation therapy prescription dose was higher in the PRT group (≥50 Gy in 94% vs 67%, P < .0001), whereas the median clinical target volume was smaller in the PRT group (553 vs 668 cm3, P = .013). Most (96%) received concurrent weekly carboplatin-paclitaxel. The mean FACT-E score was 136.3 (standard deviation [SD] 21.0) at baseline and 119.6 (SD 24.8) post-CRT, with mean change of –16.7 (SD 19.8). Baseline scores were comparable between XRT and PRT groups (135.9 vs 136.7, P = .82). On univariate and multivariate analyses, less mean decline in FACT-E score was observed for PRT versus XRT (–12.7 vs –20.6, P = .026) and for trimodality versus definitive therapy (–13.0 vs –22.5, P = .008). Conclusions: For patients receiving CRT for EC, PRT was associated with less decline in FACT-E scores compared with XRT.

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