A prospective evaluation of patient-reported quality-of-life after (chemo)radiation for oropharyngeal cancer: Which patients are at risk of significant quality-of-life deterioration?

2013 ◽  
Vol 106 (3) ◽  
pp. 359-363 ◽  
Author(s):  
Abrahim Al-Mamgani ◽  
Peter van Rooij ◽  
Lisa Tans ◽  
Gerda M. Verduijn ◽  
Aniel Sewnaik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Oropharyngeal Cancer ◽  
Prospective Evaluation ◽  
Patient Reported

Abstract 9979: Health-Related Quality of Life in Children With Marfan Syndrome

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jill C Handisides ◽  
Danielle Hollenbeck-Pringle ◽  
Karen Uzark ◽  
Felicia L Trachtenberg ◽  
Victoria L Pemberton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Marfan Syndrome ◽  
Aortic Root ◽  
Sample Mean ◽  
Population Norms ◽  
Patient Reported ◽  
Health Related ◽  
The Impact

Background: Marfan syndrome (MFS) is an autosomal dominant disorder that affects the heart, aorta, eyes, skeleton, lungs, and other organs. Objective: To assess quality of life (QL) in a large multicenter cohort of children with MFS. Methods: The Pediatric Quality of Life Inventory (PedsQL) was administered to 256 subjects with MFS ages 5-18 years as an ancillary study to the Pediatric Heart Network’s Marfan Trial, which compared the effects of atenolol vs. losartan on aortic root growth. PedsQL scores were compared to population norms by one-sample t-tests. Scores > 1 SD below the population sample mean represent at-risk status for impaired health-related QL. The impact of treatment arm (atenolol vs. losartan), severity of clinical features, and patient-reported symptoms on QL was assessed by general linear models. Results: The subjects had a mean age of 11.8±3.9 years and were 62% male, 84% white, and 88% non-Hispanic. Mean PedsQL scores for MFS subjects were significantly lower than population norms. Overall, scores were in the impaired range for physical QL and psychosocial QL in 34% and 27% of subjects, respectively. QL across multiple domains correlated negatively with frequency of patient-reported symptoms (r=0.32-0.40, p<.0001). Subjects with a reported neurodevelopmental disorder (mainly learning disability, attention deficit disorder, and/or hyperactivity) had lower mean QL scores (5.5-7.4 lower, p<.04). There were no significant differences in QL scores between treatment arms. We found no significant association between QL and aortic root z-score, extent of skeletal involvement, or presence of ectopia lentis. Conclusions: Children with MFS are at risk for impaired QL. Higher number of patient-reported symptoms had the greatest negative impact on QL, rather than treatment arm or severity of cardiac, skeletal, or ocular findings. Future interventions to address patient symptoms and neurodevelopmental disorders could improve QL for children with MFS.

Quality of life analysis of HPV-positive oropharyngeal cancer patients in a randomized trial of reduced-dose (rdCRT) versus standard (sdCRT) chemoradiotherapy: Five-year follow-up.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6062-6062
Author(s):  
Mai Takahashi ◽  
Michael Hwang ◽  
Krzysztof Misiukiewicz ◽  
Richard Lorne Bakst ◽  
Brett A. Miles ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Trial ◽  
Head And Neck ◽  
Oropharyngeal Cancer ◽  
Locally Advanced ◽  
Patient Reported ◽  
Md Anderson

6062 Background: Human papillomavirus-positive oropharyngeal cancer (HPV OPC) portends a more favorable prognosis compared to HPV-negative cases. To prevent overtreatment, long-term morbidity and deterioration in functionality and quality of life (QoL), multiple studies have focused on de-intensification techniques for HPV OPC treatment. To this end, we prospectively assessed differences in patient reported QoL in locally advanced HPV OPC patients receiving rdCRTversus sdCRT)in a randomized trial using a sequential therapy plan. Methods: Patients were enrolled between December 2012 and February 2016; received 3 cycles of induction docetaxel, cisplatin, and 5-FU; and were randomized to sdCRT (70 Gy) or rdCRT (56 Gy) with weekly carboplatin. Patients were followed for Progression Free Survival (PFS), Overall Survival (OS), and changes in QoL as assessed by the MD Anderson Dysphagia Inventory (MDADI), MD Anderson Symptom Inventory (MDASI Head and Neck), Xerostomia Questionnaire (XQ), and the European Organization for Research and Treatment of Cancer Questionnaire (EORTC QLQ-C30) with the head and neck module (EORTC HN). A mixed model ANOVA was used to estimate changes from baseline QoL to that at each follow-up timepoint and to compare the difference in QoL changes between the treatment arms. Results: We randomized 20 HPV+ locally advanced (LA) patients (median age: 56.5 yrs) to rdCRT (12 subjects) or sdCRT (8 subjects). 70% had high risk features. At a median follow-up of 81.5 mos, PFS and OS were 87.5% and 83.3% for sdCRT and rdCRT, respectively with a median OS of 76 mos in both arms. One patient in the sdCRT arm developed an HPV negative retromolar trigone squamous cell cancer in the radiation field 7 yrs after therapy. Baseline QoL was identical in the 15 patients who completed the QoL modules. Patients receiving rdCRT hadsignificantly lower declines in QoL scores at 3-6 month follow-up. At 5 yrs, differences in QoL changes all favored the rdCRT arm (Table) and two QoL scales reached statistical significance (P<0.05). Conclusions: In HPV OPC patients, rdCRT resulted in comparable long-term survival and greater improvement in specific domains of QoL when compared to sdCRT. Our results support the need for a larger, long-term Phase 3 study in LA HPVOPC to assess these two treatments with respect to survival, QoL, and safety. Clinical trial information: NCT02945631. [Table: see text]

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