Association Between Physician- and Patient-Reported Symptoms in Patients Treated With Definitive Radiation Therapy for Locally Advanced Lung Cancer in a Statewide Consortium.

Autor:	Wilkie JR; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Hochstedler KA; Department of Radiation Oncology, Spectrum Health Lakeland, St. Joseph, Michigan., Schipper MJ; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan., Matuszak MM; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Paximadis P; Department of Radiation Oncology, Spectrum Health Lakeland, St. Joseph, Michigan., Dominello MM; Department of Radiation Oncology, Barbara Ann Karmanos Cancer Center, Wayne State University School of Medicine, Detroit, Michigan., Grills I; Department of Radiation Oncology, Beaumont Royal Oak, Royal Oak, Michigan., Hayman JA; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Dess R; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Dragovic AF; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Jagsi R; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Pierce LJ; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Spratt DE; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Bergsma D; Department of Radiation Oncology, Mercy Health Saint Mary's, Grand Rapids, Michigan., Boike TP; Genesis Care/MHP Radiation Oncology Institute, Troy, Michigan., Movsas B; Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan., Jolly S; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan. Electronic address: shrutij@med.umich.edu.
Jazyk:	angličtina
Zdroj:	International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2022 Mar 15; Vol. 112 (4), pp. 942-950. Date of Electronic Publication: 2021 Nov 26.
DOI:	10.1016/j.ijrobp.2021.11.024
Abstrakt:	Purpose: Little data have been reported about the patient experience during curative radiation therapy (RT) for lung cancer in routine clinical practice or how this relates to treatment toxicity as reported by clinicians. The purpose of this study was to compare clinician-reported adverse events (AEs) with patient-reported outcomes (PROs), including both specific symptoms/side effects, as well as overall quality of life (QoL) during and after definitive RT for locally advanced lung cancer (LALC) in a large statewide cohort. Methods and Materials: PROs were prospectively collected from patients treated with definitive RT for LALC at 24 institutions within the Michigan Radiation Oncology Quality Consortium between 2012 and 2018 using the Functional Assessment of Cancer Therapy trial outcome index. Physicians prospectively recorded AEs using the Common Terminology Criteria for Adverse Events, version 4.0. Patient-reported QoL changes from baseline were assessed during and after RT using the Functional Assessment of Cancer Therapy trial outcome index. Spearman correlation coefficients were calculated for AEs and similar PROs, and a multivariable analysis was used to assess associations with QoL. Results: A total 1361 patients were included in the study, and 53% of respondents reported clinically meaningful declines in QoL at the end of RT. The correlation between clinician-reported esophagitis and patient-reported trouble swallowing was moderate (R = .67), but correlations between clinician-reported pneumonitis and patient-reported shortness of breath (R = .13) and cough (R = .09) were weak. Clinician-reported AEs were significantly associated with clinically meaningful declines in patient-reported QoL (R = - .46 for summary AE score). QoL was more strongly associated with fatigue (R = - .41) than lung-specific AEs. Conclusions: AEs are associated with clinically meaningful declines in QoL during and after RT for LALC, but associations between AEs and QoL are only modest. This highlights the importance of PRO data, and future research should assess whether earlier detection of PRO changes could allow for interventions that reduce the frequency of treatment-related clinically meaningful declines in QoL. (Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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