A quality-adjusted reanalysis of a Phase III trial comparing once-daily thoracic radiation vs. twice-daily thoracic radiation in patients with limited-stage small-cell lung cancer

Jeff A Sloan, James A. Bonner, Shauna L. Hillman, Cristine Allmer, Thomas G. Shanahan, Burke J. Brooks, Randolph Stuart Marks, Delfino Vargas-Chanes, James R. Jett

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: We undertook an analysis of quality-adjusted survival using the Q-TWiST (Quality Time Without Symptoms or Toxicity) methodology and developed a new graphic representation called a quality-adjusted life-years plot, which presents a complete and concise Q-TWiST analysis on a single plot. Methods and Materials: The Q-TWiST plot incorporates the time without symptoms or toxicity and several combinations of utility coefficients for toxicity and relapse days into the same plot. In addition, the plot includes threshold lines, to judge whether a particular combination of utility coefficients reaches a significance level. Results: The differential in toxicity incidence and severity between the two thoracic radiation treatment arms was inconsequential. Sensitivity analyses were run using Q-TWiST plots. For all combinations of the various toxicity definitions and utility coefficients, the median Q-TWiST was greater for the once-daily thoracic radiation treatment arm than for the twice-daily treatment arm, without achieved significance. Conclusion: This work refines the results previously reported for this Phase III clinical trial in patients with limited-stage small-cell cancer, and there was no significant difference in survival after adjusting for toxicity and progression. Furthermore, the new methods developed for this trial allow for a more detailed and parsimonious presentation of survival and toxicity data for all oncology clinical trials.

Original languageEnglish (US)
Pages (from-to)371-381
Number of pages11
JournalInternational Journal of Radiation Oncology Biology Physics
Volume52
Issue number2
DOIs
StatePublished - Feb 1 2002

Fingerprint

Small Cell Lung Carcinoma
toxicity
lungs
Thorax
cancer
Radiation
radiation
plots
Survival
Phase III Clinical Trials
Quality-Adjusted Life Years
coefficients
Therapeutics
Clinical Trials
Recurrence
Incidence
progressions
Neoplasms
incidence
adjusting

Keywords

  • Lung cancer
  • Quality of life
  • Quality-adjusted life-years
  • Survival analysis

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

A quality-adjusted reanalysis of a Phase III trial comparing once-daily thoracic radiation vs. twice-daily thoracic radiation in patients with limited-stage small-cell lung cancer. / Sloan, Jeff A; Bonner, James A.; Hillman, Shauna L.; Allmer, Cristine; Shanahan, Thomas G.; Brooks, Burke J.; Marks, Randolph Stuart; Vargas-Chanes, Delfino; Jett, James R.

In: International Journal of Radiation Oncology Biology Physics, Vol. 52, No. 2, 01.02.2002, p. 371-381.

Research output: Contribution to journalArticle

Sloan, Jeff A ; Bonner, James A. ; Hillman, Shauna L. ; Allmer, Cristine ; Shanahan, Thomas G. ; Brooks, Burke J. ; Marks, Randolph Stuart ; Vargas-Chanes, Delfino ; Jett, James R. / A quality-adjusted reanalysis of a Phase III trial comparing once-daily thoracic radiation vs. twice-daily thoracic radiation in patients with limited-stage small-cell lung cancer. In: International Journal of Radiation Oncology Biology Physics. 2002 ; Vol. 52, No. 2. pp. 371-381.
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