Cognition and Quality of Life After Chemotherapy Plus Radiotherapy (RT) vs. RT for Pure and Mixed Anaplastic Oligodendrogliomas

Radiation Therapy Oncology Group Trial 9402

Meihua Wang, Gregory Cairncross, Edward Shaw, Robert Brian Jenkins, Bernd Scheithauer, David Brachman, Jan Craig Buckner, Karen Fink, Luis Souhami, Normand Laperriere, Minesh Mehta, Walter Curran

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Purpose: Radiation Therapy Oncology Group 9402 compared procarbazine, lomustine, and vincristine (PCV) chemotherapy plus radiation therapy (PCV + RT) vs. RT alone for anaplastic oligodendroglioma. Here we report longitudinal changes in cognition and quality of life, effects of patient factors and treatments on cognition, quality of life and survival, and prognostic implications of cognition and quality of life. Methods and Materials: Cognition was assessed by Mini Mental Status Examination (MMSE) and quality of life by Brain-Quality of Life (B-QOL). Scores were analyzed for survivors and within 5 years of death. Shared parameter models evaluated MMSE/B-QOL with survival. Results: For survivors, MMSE and B-QOL scores were similar longitudinally and between treatments. For those who died, MMSE scores remained stable initially, whereas B-QOL slowly declined; both declined rapidly in the last year of life and similarly between arms. In the aggregate, scores decreased over time (p = 0.0413 for MMSE; p = 0.0016 for B-QOL) and were superior with age <50 years (p < 0.001 for MMSE; p = 0.0554 for B-QOL) and Karnofsky Performance Score (KPS) 80-100 (p < 0.001). Younger age and higher KPS were associated with longer survival. After adjusting for patient factors and drop-out, survival was longer after PCV + RT (HR = 0.66, 95% CI = 0.49-0.9, p = 0.0084; HR = 0.74, 95% CI = 0.54-1.01, p = 0.0592) in models with MMSE and B-QOL. In addition, there were no differences in MMSE and B-QOL scores between arms (p = 0.4752 and p = 0.2767, respectively); higher scores predicted longer survival. Conclusion: MMSE and B-QOL scores held steady in the upper range in both arms for survivors. Younger, fitter patients had better MMSE and B-QOL and longer survival.

Original languageEnglish (US)
Pages (from-to)662-669
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume77
Issue number3
DOIs
StatePublished - 2010

Fingerprint

cognition
Oligodendroglioma
Radiation Oncology
chemotherapy
Cognition
radiation therapy
Radiotherapy
Quality of Life
Drug Therapy
brain
examination
Brain
Lomustine
Procarbazine
Survival
Vincristine
Survivors
death

Keywords

  • Cognitive function
  • PCV
  • Quality of life
  • Radiotherapy
  • Randomized trial

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Cognition and Quality of Life After Chemotherapy Plus Radiotherapy (RT) vs. RT for Pure and Mixed Anaplastic Oligodendrogliomas : Radiation Therapy Oncology Group Trial 9402. / Wang, Meihua; Cairncross, Gregory; Shaw, Edward; Jenkins, Robert Brian; Scheithauer, Bernd; Brachman, David; Buckner, Jan Craig; Fink, Karen; Souhami, Luis; Laperriere, Normand; Mehta, Minesh; Curran, Walter.

In: International Journal of Radiation Oncology Biology Physics, Vol. 77, No. 3, 2010, p. 662-669.

Research output: Contribution to journalArticle

Wang, Meihua ; Cairncross, Gregory ; Shaw, Edward ; Jenkins, Robert Brian ; Scheithauer, Bernd ; Brachman, David ; Buckner, Jan Craig ; Fink, Karen ; Souhami, Luis ; Laperriere, Normand ; Mehta, Minesh ; Curran, Walter. / Cognition and Quality of Life After Chemotherapy Plus Radiotherapy (RT) vs. RT for Pure and Mixed Anaplastic Oligodendrogliomas : Radiation Therapy Oncology Group Trial 9402. In: International Journal of Radiation Oncology Biology Physics. 2010 ; Vol. 77, No. 3. pp. 662-669.
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abstract = "Purpose: Radiation Therapy Oncology Group 9402 compared procarbazine, lomustine, and vincristine (PCV) chemotherapy plus radiation therapy (PCV + RT) vs. RT alone for anaplastic oligodendroglioma. Here we report longitudinal changes in cognition and quality of life, effects of patient factors and treatments on cognition, quality of life and survival, and prognostic implications of cognition and quality of life. Methods and Materials: Cognition was assessed by Mini Mental Status Examination (MMSE) and quality of life by Brain-Quality of Life (B-QOL). Scores were analyzed for survivors and within 5 years of death. Shared parameter models evaluated MMSE/B-QOL with survival. Results: For survivors, MMSE and B-QOL scores were similar longitudinally and between treatments. For those who died, MMSE scores remained stable initially, whereas B-QOL slowly declined; both declined rapidly in the last year of life and similarly between arms. In the aggregate, scores decreased over time (p = 0.0413 for MMSE; p = 0.0016 for B-QOL) and were superior with age <50 years (p < 0.001 for MMSE; p = 0.0554 for B-QOL) and Karnofsky Performance Score (KPS) 80-100 (p < 0.001). Younger age and higher KPS were associated with longer survival. After adjusting for patient factors and drop-out, survival was longer after PCV + RT (HR = 0.66, 95{\%} CI = 0.49-0.9, p = 0.0084; HR = 0.74, 95{\%} CI = 0.54-1.01, p = 0.0592) in models with MMSE and B-QOL. In addition, there were no differences in MMSE and B-QOL scores between arms (p = 0.4752 and p = 0.2767, respectively); higher scores predicted longer survival. Conclusion: MMSE and B-QOL scores held steady in the upper range in both arms for survivors. Younger, fitter patients had better MMSE and B-QOL and longer survival.",
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AU - Cairncross, Gregory

AU - Shaw, Edward

AU - Jenkins, Robert Brian

AU - Scheithauer, Bernd

AU - Brachman, David

AU - Buckner, Jan Craig

AU - Fink, Karen

AU - Souhami, Luis

AU - Laperriere, Normand

AU - Mehta, Minesh

AU - Curran, Walter

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