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Title: Phase 1/2 Trial of 5-Fraction Stereotactic Radiosurgery With 5-mm Margins With Concurrent and Adjuvant Temozolomide in Newly Diagnosed Supratentorial Glioblastoma: Health-Related Quality of Life Results

Abstract

Purpose: We report a longitudinal assessment of health-related quality of life (HRQOL) in patients with glioblastoma (GBM) treated on a prospective dose escalation trial of 5-fraction stereotactic radiosurgery (25-40 Gy in 5 fractions) with concurrent and adjuvant temozolomide. Methods: HRQOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire core-30 (QLQ-C30) general, the EORTC quality of life questionnaire-brain cancer specific module (QLQ-BN20), and the M.D. Anderson Symptom Inventory–Brain Tumor (MDASI-BT). Questionnaires were completed at baseline and at every follow-up visit after completion of radiosurgery. Changes from baseline for 9 predefined HRQOL measures (global quality of life, physical functioning, social functioning, emotional functioning, motor dysfunction, communication deficit, fatigue, insomnia, and future uncertainty) were calculated at every time point. Results: With a median follow-up time of 10.4 months (range, 0.4-52 months), 139 total HRQOL questionnaires were completed by the 30 patients on trial. Compliance with HRQOL assessment was 76% at 12 months. Communication deficit significantly worsened over time, with a decline of 1.7 points per month (P=.008). No significant changes over time were detected in the other 8 scales of our primary analysis, including global quality of life. Although 8 patients (27%) experienced adverse radiation effects (ARE) onmore » this dose escalation trial, it was not associated with a statistically significant decline in any of the primary HRQOL scales. Disease progression was associated with communication deficit, with patients experiencing an average worsening of 13.9 points per month after progression compared with 0.7 points per month before progression (P=.01). Conclusion: On this 5-fraction dose escalation protocol for newly diagnosed GBM, overall HRQOL remained stable and appears similar to historical controls of 30 fractions of radiation therapy. Tumor recurrence was associated with worsening communication deficit, and ARE did not correlate with a decline in HRQOL.« less

Authors:
; ; ; ; ;  [1];  [1];  [2]; ; ; ;  [1]; ; ; ; ;  [3]; ; ;  [3] more »;  [4];  [1];  [4]; « less
  1. Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States)
  2. (Canada)
  3. Department of Neurosurgery, Stanford University School of Medicine, Stanford, California (United States)
  4. (United States)
Publication Date:
OSTI Identifier:
22649915
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 98; Journal Issue: 1; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; GLIOMAS; GY RANGE 10-100; PATIENTS; RADIATION DOSES; RADIATION EFFECTS; RADIOTHERAPY; SURGERY

Citation Formats

Pollom, Erqi L., Fujimoto, Dylann, Wynne, Jacob, Seiger, Kira, Modlin, Leslie A., Jacobs, Lisa R., Azoulay, Melissa, Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Eyben, Rie von, Tupper, Laurie, Gibbs, Iris C., Hancock, Steven L., Li, Gordon, Chang, Steven D., Adler, John R., Harsh, Griffith R., Harraher, Ciara, Nagpal, Seema, Thomas, Reena P., Recht, Lawrence D., Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, Choi, Clara Y.H., Department of Radiation Oncology, Santa Clara Valley Medical Center, San Jose, California, and and others. Phase 1/2 Trial of 5-Fraction Stereotactic Radiosurgery With 5-mm Margins With Concurrent and Adjuvant Temozolomide in Newly Diagnosed Supratentorial Glioblastoma: Health-Related Quality of Life Results. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2017.01.242.
Pollom, Erqi L., Fujimoto, Dylann, Wynne, Jacob, Seiger, Kira, Modlin, Leslie A., Jacobs, Lisa R., Azoulay, Melissa, Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Eyben, Rie von, Tupper, Laurie, Gibbs, Iris C., Hancock, Steven L., Li, Gordon, Chang, Steven D., Adler, John R., Harsh, Griffith R., Harraher, Ciara, Nagpal, Seema, Thomas, Reena P., Recht, Lawrence D., Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, Choi, Clara Y.H., Department of Radiation Oncology, Santa Clara Valley Medical Center, San Jose, California, & and others. Phase 1/2 Trial of 5-Fraction Stereotactic Radiosurgery With 5-mm Margins With Concurrent and Adjuvant Temozolomide in Newly Diagnosed Supratentorial Glioblastoma: Health-Related Quality of Life Results. United States. doi:10.1016/J.IJROBP.2017.01.242.
Pollom, Erqi L., Fujimoto, Dylann, Wynne, Jacob, Seiger, Kira, Modlin, Leslie A., Jacobs, Lisa R., Azoulay, Melissa, Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Eyben, Rie von, Tupper, Laurie, Gibbs, Iris C., Hancock, Steven L., Li, Gordon, Chang, Steven D., Adler, John R., Harsh, Griffith R., Harraher, Ciara, Nagpal, Seema, Thomas, Reena P., Recht, Lawrence D., Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, Choi, Clara Y.H., Department of Radiation Oncology, Santa Clara Valley Medical Center, San Jose, California, and and others. Mon . "Phase 1/2 Trial of 5-Fraction Stereotactic Radiosurgery With 5-mm Margins With Concurrent and Adjuvant Temozolomide in Newly Diagnosed Supratentorial Glioblastoma: Health-Related Quality of Life Results". United States. doi:10.1016/J.IJROBP.2017.01.242.
@article{osti_22649915,
title = {Phase 1/2 Trial of 5-Fraction Stereotactic Radiosurgery With 5-mm Margins With Concurrent and Adjuvant Temozolomide in Newly Diagnosed Supratentorial Glioblastoma: Health-Related Quality of Life Results},
author = {Pollom, Erqi L. and Fujimoto, Dylann and Wynne, Jacob and Seiger, Kira and Modlin, Leslie A. and Jacobs, Lisa R. and Azoulay, Melissa and Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec and Eyben, Rie von and Tupper, Laurie and Gibbs, Iris C. and Hancock, Steven L. and Li, Gordon and Chang, Steven D. and Adler, John R. and Harsh, Griffith R. and Harraher, Ciara and Nagpal, Seema and Thomas, Reena P. and Recht, Lawrence D. and Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California and Choi, Clara Y.H. and Department of Radiation Oncology, Santa Clara Valley Medical Center, San Jose, California and and others},
abstractNote = {Purpose: We report a longitudinal assessment of health-related quality of life (HRQOL) in patients with glioblastoma (GBM) treated on a prospective dose escalation trial of 5-fraction stereotactic radiosurgery (25-40 Gy in 5 fractions) with concurrent and adjuvant temozolomide. Methods: HRQOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire core-30 (QLQ-C30) general, the EORTC quality of life questionnaire-brain cancer specific module (QLQ-BN20), and the M.D. Anderson Symptom Inventory–Brain Tumor (MDASI-BT). Questionnaires were completed at baseline and at every follow-up visit after completion of radiosurgery. Changes from baseline for 9 predefined HRQOL measures (global quality of life, physical functioning, social functioning, emotional functioning, motor dysfunction, communication deficit, fatigue, insomnia, and future uncertainty) were calculated at every time point. Results: With a median follow-up time of 10.4 months (range, 0.4-52 months), 139 total HRQOL questionnaires were completed by the 30 patients on trial. Compliance with HRQOL assessment was 76% at 12 months. Communication deficit significantly worsened over time, with a decline of 1.7 points per month (P=.008). No significant changes over time were detected in the other 8 scales of our primary analysis, including global quality of life. Although 8 patients (27%) experienced adverse radiation effects (ARE) on this dose escalation trial, it was not associated with a statistically significant decline in any of the primary HRQOL scales. Disease progression was associated with communication deficit, with patients experiencing an average worsening of 13.9 points per month after progression compared with 0.7 points per month before progression (P=.01). Conclusion: On this 5-fraction dose escalation protocol for newly diagnosed GBM, overall HRQOL remained stable and appears similar to historical controls of 30 fractions of radiation therapy. Tumor recurrence was associated with worsening communication deficit, and ARE did not correlate with a decline in HRQOL.},
doi = {10.1016/J.IJROBP.2017.01.242},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 98,
place = {United States},
year = {Mon May 01 00:00:00 EDT 2017},
month = {Mon May 01 00:00:00 EDT 2017}
}