title: Quality of Life and Performance Status From a Substudy Conducted Within a Prospective Phase 3 Randomized Trial of Concurrent Standard Radiation Versus Accelerated Radiation Plus Cisplatin for Locally Advanced Head and Neck Carcinoma: NRG Oncology RTOG 0129.
abstract: To analyze quality of life (QOL) and performance status (PS) for head and neck cancer (HNC) patients treated on NRG Oncology RTOG 0129 by treatment (secondary outcome) and p16 status, and to examine the association between QOL/PS and survival.
  
  
  
  Eligible patients were randomized into either an accelerated-fractionation arm or a standard-fractionation arm, and completed the Performance Status Scale for the Head and Neck (PSS-HN), the Head and Neck Radiotherapy Questionnaire (HNRQ), and the Spitzer Quality of Life Index (SQLI) at 8 time points from before treatment to 5 years after treatment.
  
  
  
  The results from the analysis of area under the curve showed that QOL/PS was not significantly different between the 2 arms from baseline to year after treatment (P ranged from .39 to .98). The results from general linear mixed models further supported the nonsignificant treatment effects until 5 years after treatment (P=.95, .90, and .84 for PSS-HN Diet, Eating, and Speech, respectively). Before treatment and after 1 year after treatment, p16-positive oropharyngeal cancer (OPC) patients had better QOL than did p16-negative patients (P ranged from .0283 to <.0001 for all questionnaires). However, QOL/PS decreased more significantly from pretreatment to the last 2 weeks of treatment in the p16-positive group than in the p16-negative group (P ranged from .0002 to <.0001). Pretreatment QOL/PS was a significant independent predictor of overall survival, progression-free survival, and local-regional failure but not of distant metastasis (P ranged from .0063 to <.0001).
  
  
  
  The results indicated that patients in both arms may have experienced similar QOL/PS. p16-positive patients had better QOL/PS at baseline and after 1 year of follow-up. Patients presenting with better baseline QOL/PS scores had better survival.
authors.affiliation: Emory University, Atlanta, Georgia. Electronic address: canhua.xiao@emory.edu.
authors.forename: Canhua
authors.initials: C
authors.lastname: Xiao
authors.affiliation: NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Centre Hospitalier de l'Université de Montréal-Notre Dame, Montréal, Quebec, Canada.
authors.forename: Phuc Felix
authors.initials: PF
authors.lastname: Nguyen-Tân
authors.affiliation: The University of Chicago, Chicago, Illinois.
authors.forename: Marcie
authors.initials: M
authors.lastname: List
authors.affiliation: University of Texas-MD Anderson Cancer Center, Houston, Texas.
authors.forename: Randal S
authors.initials: RS
authors.lastname: Weber
authors.affiliation: University of Texas-MD Anderson Cancer Center, Houston, Texas.
authors.forename: K Kian
authors.initials: KK
authors.lastname: Ang
authors.affiliation: University of Texas-MD Anderson Cancer Center, Houston, Texas.
authors.forename: David
authors.initials: D
authors.lastname: Rosenthal
authors.affiliation: Centre Hospitalier de l'Université de Montréal-Notre Dame, Montréal, Quebec, Canada.
authors.forename: Edith J
authors.initials: EJ
authors.lastname: Filion
authors.affiliation: Wayne State University, Karmanos Cancer Center, Detroit, Michigan.
authors.forename: Harold
authors.initials: H
authors.lastname: Kim
authors.affiliation: James Graham Brown Cancer Center-University of Louisville, Louisville, Kentucky.
authors.forename: Craig
authors.initials: C
authors.lastname: Silverman
authors.affiliation: Christiana Care Health Services, Inc, CCOP, Newark, Delaware.
authors.forename: Adam
authors.initials: A
authors.lastname: Raben
authors.affiliation: Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Thomas
authors.initials: T
authors.lastname: Galloway
authors.affiliation: L Hotel-Dieu de Quebec, Québec City, Quebec, Canada.
authors.forename: Andre
authors.initials: A
authors.lastname: Fortin
authors.affiliation: Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gore
authors.affiliation: London Regional Cancer Program, London, Ontario, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Winquist
authors.affiliation: Sutter General Hospital, Formerly Radiological Associates of Sacramento, Sacramento, California.
authors.forename: Christopher U
authors.initials: CU
authors.lastname: Jones
authors.affiliation: Tulane University Medical Center, New Orleans, Louisiana.
authors.forename: William
authors.initials: W
authors.lastname: Robinson
authors.affiliation: University of Colorado, Denver, Colorado.
authors.forename: David
authors.initials: D
authors.lastname: Raben
authors.affiliation: Stanford University Medical Center, Stanford, California.
authors.forename: Quynh-Thu
authors.initials: QT
authors.lastname: Le
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Bruner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D059248:Chemoradiotherapy / Q000401:mortality* / Q000523:psychology* / Q000706:statistics & numerical data; D002945:Cisplatin / Q000008:administration & dosage; D019583:Dose Fractionation, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000517:prevention & control* / Q000523:psychology; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin