Continuing evidence for poorer treatment outcomes for single male patients: retreatment data from RTOG 97-14.
OBJECTIVE
The specific aim of this study was to evaluate outcome differences by gender and partner status for patients treated on Radiation Therapy Oncology Group (RTOG) protocol 97-14.


METHODS
RTOG 97-14 randomized patients with metastatic breast or prostate cancer to bone to receive 8 Gy in 1 fraction or 30 Gy in 10 fractions. Retreatment rates and overall survival were made based upon gender, marital status, and Karnofsky Performance Status (KPS). The cumulative incidence method was used to estimate retreatment time at 36 months from enrollment, and Gray's test was used to test for treatment differences within the same groupings. Marital status, gender, KPS, and treatment were variables tested in a univariate Cox model evaluating the time to retreatment.


RESULTS
Married men and women and single women receiving 30 Gy had significantly longer time to retreatment, p = 0.0067, p = 0.0052, and p = 0.0009 respectively. We failed to show a difference in retreatment rates over time in single men receiving either 30 Gy or 8 Gy. Univariate analysis of the entire group determined patients receiving 30 Gy in 10 fractions significantly less likely to receive retreatment, p < 0.0001, with a trend toward single patients less likely to be re-treated, p = 0.07.


CONCLUSIONS
Non-disease-related variables, such as social support, might influence the results of clinical trials with subjective endpoints such as retreatment rates. The statistically nonsignificant difference in the 36-month retreatment rates observed in single male patients receiving 8 Gy may be a result of inadequate social support systems in place to facilitate additional care. Patients receiving 8 Gy in a single fraction had significantly higher retreatment rates compared with patients receiving 30 Gy in 10 fractions.
Konski
Andre
A
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA. andre.konski@fccc.edu
Desilvio
Michelle
M
Hartsell
William
W
Watkins-Bruner
Deborah
D
Coyne
James
J
Scarantino
Charles
C
Janjan
Nora
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D010147:Pain Measurement; D010166:Palliative Care; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D019233:Retreatment / Q000706:statistics & numerical data; D012737:Sex Factors; D012847:Single Person; D016896:Treatment Outcome