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Prospective evaluation of acute toxicity and patient reported outcomes in anal cancer and plan optimization

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Kronborg, Camilla ; Serup-Hansen, Eva ; Lefevre, Anna ; Wilken, Eva E ; Petersen, Jørgen B ; Hansen, Jolanta ; Schouboe, Annette ; Nyvang, Lars ; Spindler, Karen-Lise G. / Prospective evaluation of acute toxicity and patient reported outcomes in anal cancer and plan optimization. In: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2018 ; Vol. 128, No. 2. pp. 375-379.

Bibtex

@article{328a952308074cdc8d33888fbcaa6db5,
title = "Prospective evaluation of acute toxicity and patient reported outcomes in anal cancer and plan optimization",
abstract = "BACKGROUND AND PURPOSE: Chemoradiotherapy (CRT) is the standard therapy for localized anal cancer (AC), but this treatment is associated with substantial toxicity. However, there is a lack of prospectively collected toxicity and patient reported outcome (PRO) data from larger cohorts. The purpose was to prospectively collect and determine agreement between physician assessed toxicity (CTCAE) and PRO during and after CRT and to compare IMRT, VMAT and proton-based planning in a subgroup of patients.MATERIAL AND METHODS: Patients, treated with CRT for AC, were included between 2015 and 2017. NCI-CTCAE v.4.0, EORTC QLQ-C30 and CR29 data were collected baseline, mid-therapy, end-of therapy and 2-4 weeks posttherapy. Treatment planning with 5- or 6-fixed field IMRT, 2 and 3 arc VMAT, and 3- and 4-field proton plans were compared.RESULTS: One-hundred patients were included. Both CTCAE and PROs related to acute toxicity reached a maximum at end of therapy. Incidences of PROs were markedly higher with only slight to fair agreement to CTCAE, (κ 13-37). Comparative planning revealed dosimetric equality of IMRT and VMAT plans, but superiority of proton plans.CONCLUSIONS: The high incidence of PRO scores and weak agreement to CTCAE suggest that PROs are important tools complementary to CTCAE in evaluating patient symptoms during and after CRT. Proton therapy has the potential to lower radiation doses to most organs at risk.",
keywords = "Aged, Anal Canal/drug effects, Anus Neoplasms/therapy, Chemoradiotherapy/adverse effects, Female, Humans, Male, Middle Aged, Patient Reported Outcome Measures, Prospective Studies, Protons, Quality of Life, Radiometry, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted/methods, Radiotherapy, Intensity-Modulated/adverse effects",
author = "Camilla Kronborg and Eva Serup-Hansen and Anna Lefevre and Wilken, {Eva E} and Petersen, {J{\o}rgen B} and Jolanta Hansen and Annette Schouboe and Lars Nyvang and Spindler, {Karen-Lise G}",
note = "Copyright {\circledC} 2018 Elsevier B.V. All rights reserved.",
year = "2018",
month = "8",
doi = "10.1016/j.radonc.2018.06.006",
language = "English",
volume = "128",
pages = "375--379",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - Prospective evaluation of acute toxicity and patient reported outcomes in anal cancer and plan optimization

AU - Kronborg, Camilla

AU - Serup-Hansen, Eva

AU - Lefevre, Anna

AU - Wilken, Eva E

AU - Petersen, Jørgen B

AU - Hansen, Jolanta

AU - Schouboe, Annette

AU - Nyvang, Lars

AU - Spindler, Karen-Lise G

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2018/8

Y1 - 2018/8

N2 - BACKGROUND AND PURPOSE: Chemoradiotherapy (CRT) is the standard therapy for localized anal cancer (AC), but this treatment is associated with substantial toxicity. However, there is a lack of prospectively collected toxicity and patient reported outcome (PRO) data from larger cohorts. The purpose was to prospectively collect and determine agreement between physician assessed toxicity (CTCAE) and PRO during and after CRT and to compare IMRT, VMAT and proton-based planning in a subgroup of patients.MATERIAL AND METHODS: Patients, treated with CRT for AC, were included between 2015 and 2017. NCI-CTCAE v.4.0, EORTC QLQ-C30 and CR29 data were collected baseline, mid-therapy, end-of therapy and 2-4 weeks posttherapy. Treatment planning with 5- or 6-fixed field IMRT, 2 and 3 arc VMAT, and 3- and 4-field proton plans were compared.RESULTS: One-hundred patients were included. Both CTCAE and PROs related to acute toxicity reached a maximum at end of therapy. Incidences of PROs were markedly higher with only slight to fair agreement to CTCAE, (κ 13-37). Comparative planning revealed dosimetric equality of IMRT and VMAT plans, but superiority of proton plans.CONCLUSIONS: The high incidence of PRO scores and weak agreement to CTCAE suggest that PROs are important tools complementary to CTCAE in evaluating patient symptoms during and after CRT. Proton therapy has the potential to lower radiation doses to most organs at risk.

AB - BACKGROUND AND PURPOSE: Chemoradiotherapy (CRT) is the standard therapy for localized anal cancer (AC), but this treatment is associated with substantial toxicity. However, there is a lack of prospectively collected toxicity and patient reported outcome (PRO) data from larger cohorts. The purpose was to prospectively collect and determine agreement between physician assessed toxicity (CTCAE) and PRO during and after CRT and to compare IMRT, VMAT and proton-based planning in a subgroup of patients.MATERIAL AND METHODS: Patients, treated with CRT for AC, were included between 2015 and 2017. NCI-CTCAE v.4.0, EORTC QLQ-C30 and CR29 data were collected baseline, mid-therapy, end-of therapy and 2-4 weeks posttherapy. Treatment planning with 5- or 6-fixed field IMRT, 2 and 3 arc VMAT, and 3- and 4-field proton plans were compared.RESULTS: One-hundred patients were included. Both CTCAE and PROs related to acute toxicity reached a maximum at end of therapy. Incidences of PROs were markedly higher with only slight to fair agreement to CTCAE, (κ 13-37). Comparative planning revealed dosimetric equality of IMRT and VMAT plans, but superiority of proton plans.CONCLUSIONS: The high incidence of PRO scores and weak agreement to CTCAE suggest that PROs are important tools complementary to CTCAE in evaluating patient symptoms during and after CRT. Proton therapy has the potential to lower radiation doses to most organs at risk.

KW - Aged

KW - Anal Canal/drug effects

KW - Anus Neoplasms/therapy

KW - Chemoradiotherapy/adverse effects

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Reported Outcome Measures

KW - Prospective Studies

KW - Protons

KW - Quality of Life

KW - Radiometry

KW - Radiotherapy Dosage

KW - Radiotherapy Planning, Computer-Assisted/methods

KW - Radiotherapy, Intensity-Modulated/adverse effects

U2 - 10.1016/j.radonc.2018.06.006

DO - 10.1016/j.radonc.2018.06.006

M3 - Journal article

VL - 128

SP - 375

EP - 379

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

SN - 0167-8140

IS - 2

ER -

ID: 56565148