Longitudinal quality-of-life analysis of RTOG 94-05 (Int 0123): A phase III trial of definitive chemoradiotherapy for esophageal cancer

Lisa A. Kachnic, Kathryn Winter, Todd Wasserman, David Kelsen, Robert Ginsberg, Thomas M. Pisansky, James Martenson, Ritsuko Komaki, Gordon Okawara, Seth A. Rosenthal, Christopher G. Willett, Bruce D. Minsky

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Longitudinal quality of life (QoL) was compared for patients with esophageal cancer receiving definitive chemoradiotherapy (CRT) with conventional-dose (CD) vs. high-dose (HD) radiotherapy as used in the RTOG phase III 94-05 trial (Intergroup 0123). Methods: Between June 12, 1995, and July 1, 1999, 236 patients with cT1-4NxM0 esophageal cancer were randomized to CD CRT (50.4 Gy and concurrent 5-fluorouracil and cisplatin) vs. HD CRT (64.8 Gy and the same chemotherapy). QoL was assessed using the Functional Assessment of Cancer Therapy, Head & Neck (version 2) at baseline, after CRT, at 8 months from the start of CRT, and at 1 year. Results: Of 218 eligible patients, 166 participated in pretreatment QoL assessments (82 HD, 84 CD). Patients with ≥10% weight loss and Karnofsky Performance Status 60-80 were less likely to participate (P=.02 and P=.002, respectively). Pretreatment characteristics for participating patients were similar in both arms. At CRT completion, 96 patients completed QoL (46 HD, 50 CD) assessment. Total mean QoL was significantly lower in the HD arm (P=.02) and remained lower at 8 and 12 months after the start of CRT, but these values did not reach statistical significance. Change in mean QoL from baseline to each of the three subsequent assessment time points did not differ significantly between the two treatment arms. Conclusions: For patients treated with definitive CRT for esophageal cancer, radiation dose escalation to 64.8 Gy does not significantly improve QoL. These results provide additional evidence that radiotherapy to 50.4 Gy should remain the standard of care.

Original languageEnglish (US)
Pages (from-to)45-52
Number of pages8
JournalGastrointestinal Cancer Research
Volume4
Issue number2
StatePublished - Mar 2011

Fingerprint

Chemoradiotherapy
Esophageal Neoplasms
Quality of Life
Arm
Radiotherapy
Karnofsky Performance Status
Standard of Care
Head and Neck Neoplasms
Fluorouracil
Cisplatin
Weight Loss
Neck
Radiation
Drug Therapy
Therapeutics

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Kachnic, L. A., Winter, K., Wasserman, T., Kelsen, D., Ginsberg, R., Pisansky, T. M., ... Minsky, B. D. (2011). Longitudinal quality-of-life analysis of RTOG 94-05 (Int 0123): A phase III trial of definitive chemoradiotherapy for esophageal cancer. Gastrointestinal Cancer Research, 4(2), 45-52.

Longitudinal quality-of-life analysis of RTOG 94-05 (Int 0123) : A phase III trial of definitive chemoradiotherapy for esophageal cancer. / Kachnic, Lisa A.; Winter, Kathryn; Wasserman, Todd; Kelsen, David; Ginsberg, Robert; Pisansky, Thomas M.; Martenson, James; Komaki, Ritsuko; Okawara, Gordon; Rosenthal, Seth A.; Willett, Christopher G.; Minsky, Bruce D.

In: Gastrointestinal Cancer Research, Vol. 4, No. 2, 03.2011, p. 45-52.

Research output: Contribution to journalArticle

Kachnic, LA, Winter, K, Wasserman, T, Kelsen, D, Ginsberg, R, Pisansky, TM, Martenson, J, Komaki, R, Okawara, G, Rosenthal, SA, Willett, CG & Minsky, BD 2011, 'Longitudinal quality-of-life analysis of RTOG 94-05 (Int 0123): A phase III trial of definitive chemoradiotherapy for esophageal cancer', Gastrointestinal Cancer Research, vol. 4, no. 2, pp. 45-52.
Kachnic, Lisa A. ; Winter, Kathryn ; Wasserman, Todd ; Kelsen, David ; Ginsberg, Robert ; Pisansky, Thomas M. ; Martenson, James ; Komaki, Ritsuko ; Okawara, Gordon ; Rosenthal, Seth A. ; Willett, Christopher G. ; Minsky, Bruce D. / Longitudinal quality-of-life analysis of RTOG 94-05 (Int 0123) : A phase III trial of definitive chemoradiotherapy for esophageal cancer. In: Gastrointestinal Cancer Research. 2011 ; Vol. 4, No. 2. pp. 45-52.
@article{97976e653a754e519681700014738484,
title = "Longitudinal quality-of-life analysis of RTOG 94-05 (Int 0123): A phase III trial of definitive chemoradiotherapy for esophageal cancer",
abstract = "Background: Longitudinal quality of life (QoL) was compared for patients with esophageal cancer receiving definitive chemoradiotherapy (CRT) with conventional-dose (CD) vs. high-dose (HD) radiotherapy as used in the RTOG phase III 94-05 trial (Intergroup 0123). Methods: Between June 12, 1995, and July 1, 1999, 236 patients with cT1-4NxM0 esophageal cancer were randomized to CD CRT (50.4 Gy and concurrent 5-fluorouracil and cisplatin) vs. HD CRT (64.8 Gy and the same chemotherapy). QoL was assessed using the Functional Assessment of Cancer Therapy, Head & Neck (version 2) at baseline, after CRT, at 8 months from the start of CRT, and at 1 year. Results: Of 218 eligible patients, 166 participated in pretreatment QoL assessments (82 HD, 84 CD). Patients with ≥10{\%} weight loss and Karnofsky Performance Status 60-80 were less likely to participate (P=.02 and P=.002, respectively). Pretreatment characteristics for participating patients were similar in both arms. At CRT completion, 96 patients completed QoL (46 HD, 50 CD) assessment. Total mean QoL was significantly lower in the HD arm (P=.02) and remained lower at 8 and 12 months after the start of CRT, but these values did not reach statistical significance. Change in mean QoL from baseline to each of the three subsequent assessment time points did not differ significantly between the two treatment arms. Conclusions: For patients treated with definitive CRT for esophageal cancer, radiation dose escalation to 64.8 Gy does not significantly improve QoL. These results provide additional evidence that radiotherapy to 50.4 Gy should remain the standard of care.",
author = "Kachnic, {Lisa A.} and Kathryn Winter and Todd Wasserman and David Kelsen and Robert Ginsberg and Pisansky, {Thomas M.} and James Martenson and Ritsuko Komaki and Gordon Okawara and Rosenthal, {Seth A.} and Willett, {Christopher G.} and Minsky, {Bruce D.}",
year = "2011",
month = "3",
language = "English (US)",
volume = "4",
pages = "45--52",
journal = "Gastrointestinal Cancer Research",
issn = "1934-7820",
publisher = "International Society of Gastrointestinal Oncology",
number = "2",

}

TY - JOUR

T1 - Longitudinal quality-of-life analysis of RTOG 94-05 (Int 0123)

T2 - A phase III trial of definitive chemoradiotherapy for esophageal cancer

AU - Kachnic, Lisa A.

AU - Winter, Kathryn

AU - Wasserman, Todd

AU - Kelsen, David

AU - Ginsberg, Robert

AU - Pisansky, Thomas M.

AU - Martenson, James

AU - Komaki, Ritsuko

AU - Okawara, Gordon

AU - Rosenthal, Seth A.

AU - Willett, Christopher G.

AU - Minsky, Bruce D.

PY - 2011/3

Y1 - 2011/3

N2 - Background: Longitudinal quality of life (QoL) was compared for patients with esophageal cancer receiving definitive chemoradiotherapy (CRT) with conventional-dose (CD) vs. high-dose (HD) radiotherapy as used in the RTOG phase III 94-05 trial (Intergroup 0123). Methods: Between June 12, 1995, and July 1, 1999, 236 patients with cT1-4NxM0 esophageal cancer were randomized to CD CRT (50.4 Gy and concurrent 5-fluorouracil and cisplatin) vs. HD CRT (64.8 Gy and the same chemotherapy). QoL was assessed using the Functional Assessment of Cancer Therapy, Head & Neck (version 2) at baseline, after CRT, at 8 months from the start of CRT, and at 1 year. Results: Of 218 eligible patients, 166 participated in pretreatment QoL assessments (82 HD, 84 CD). Patients with ≥10% weight loss and Karnofsky Performance Status 60-80 were less likely to participate (P=.02 and P=.002, respectively). Pretreatment characteristics for participating patients were similar in both arms. At CRT completion, 96 patients completed QoL (46 HD, 50 CD) assessment. Total mean QoL was significantly lower in the HD arm (P=.02) and remained lower at 8 and 12 months after the start of CRT, but these values did not reach statistical significance. Change in mean QoL from baseline to each of the three subsequent assessment time points did not differ significantly between the two treatment arms. Conclusions: For patients treated with definitive CRT for esophageal cancer, radiation dose escalation to 64.8 Gy does not significantly improve QoL. These results provide additional evidence that radiotherapy to 50.4 Gy should remain the standard of care.

AB - Background: Longitudinal quality of life (QoL) was compared for patients with esophageal cancer receiving definitive chemoradiotherapy (CRT) with conventional-dose (CD) vs. high-dose (HD) radiotherapy as used in the RTOG phase III 94-05 trial (Intergroup 0123). Methods: Between June 12, 1995, and July 1, 1999, 236 patients with cT1-4NxM0 esophageal cancer were randomized to CD CRT (50.4 Gy and concurrent 5-fluorouracil and cisplatin) vs. HD CRT (64.8 Gy and the same chemotherapy). QoL was assessed using the Functional Assessment of Cancer Therapy, Head & Neck (version 2) at baseline, after CRT, at 8 months from the start of CRT, and at 1 year. Results: Of 218 eligible patients, 166 participated in pretreatment QoL assessments (82 HD, 84 CD). Patients with ≥10% weight loss and Karnofsky Performance Status 60-80 were less likely to participate (P=.02 and P=.002, respectively). Pretreatment characteristics for participating patients were similar in both arms. At CRT completion, 96 patients completed QoL (46 HD, 50 CD) assessment. Total mean QoL was significantly lower in the HD arm (P=.02) and remained lower at 8 and 12 months after the start of CRT, but these values did not reach statistical significance. Change in mean QoL from baseline to each of the three subsequent assessment time points did not differ significantly between the two treatment arms. Conclusions: For patients treated with definitive CRT for esophageal cancer, radiation dose escalation to 64.8 Gy does not significantly improve QoL. These results provide additional evidence that radiotherapy to 50.4 Gy should remain the standard of care.

UR - http://www.scopus.com/inward/record.url?scp=80053021673&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053021673&partnerID=8YFLogxK

M3 - Article

C2 - 21673875

AN - SCOPUS:80053021673

VL - 4

SP - 45

EP - 52

JO - Gastrointestinal Cancer Research

JF - Gastrointestinal Cancer Research

SN - 1934-7820

IS - 2

ER -