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Tyler MA, Mohamed ASR, Smith JB, Aymard JM, Fuller CD, Phan J, Frank SJ, Ferrarotto R, Kupferman ME, Hanna EY, Gunn GB, Su SY. Long-term quality of life after definitive treatment of sinonasal and nasopharyngeal malignancies. Laryngoscope 2019; 130:86-93. [PMID: 30706478 DOI: 10.1002/lary.27849] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 12/17/2018] [Accepted: 01/08/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate long-term global and site-specific health-related quality of life (HRQoL) in patients treated for sinonasal and nasopharyngeal malignancies. STUDY DESIGN Cross-sectional. METHODS One hundred fourteen patients with sinonasal and nasopharyngeal malignancies received surgery, radiation, systemic chemotherapy, or a combination thereof, with curative intent. Validated global ([EuroQol-5D] Visual Analogue Scale [EQ-5D VAS]) and disease-specific instruments (MD Anderson Symptom Inventory-Head and Neck [MDASI-HN], Anterior Skull Base Questionnaire [ASBQ]) were administered to patients who were both free of disease and had completed treatment at least 12 months previously. Associations between instruments, instrument domains, and specific clinical parameters were analyzed. RESULTS The median age was 55 years. The mean EQ-5D VAS, MDASI-22 composite score, and ASBQ score were 74 (standard deviation [SD] 21), 48 (SD 36), and 130 (SD 27), respectively. The most frequently reported high-severity items in MDASI-HN were dry mouth and difficulty tasting food. The most frequently reported high-severity items in ASBQ were difficulty with smell and nasal secretions. Advanced Tumor (T) classification was associated with worse overall ASBQ sum score (P = 0.02). ASBQ performance at home and MDASI-HN drowsy symptom items independently predicted worse global HRQoL as measured by the EQ-5D VAS (P < 0.001). CONCLUSION Global HRQoL for survivors of sinonasal and nasopharyngeal malignancies after multimodality treatment approximates that of the U.S. population for the same age group. ASBQ and MDASI-HN correlate well with global HRQoL outcomes as measured by EQ-5D VAS. MDASI-HN and ASBQ elicited unique symptoms, highlighting the complex symptom burden experienced by these patients. Further studies should identify patients predisposed to reduced long-term QOL. LEVEL OF EVIDENCE 3 Laryngoscope, 130:86-93, 2020.
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Affiliation(s)
- Matthew A Tyler
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School at the University of Texas Health Science Center
| | - Abdallah S R Mohamed
- the Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston
| | - Joshua B Smith
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School at the University of Texas Health Science Center
| | - Jeremy M Aymard
- the Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston.,Abilene Christian University, Abilene, Texas, U.S.A
| | - Clifton D Fuller
- the Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston
| | - Jack Phan
- the Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston
| | - Steven J Frank
- the Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston
| | - Renata Ferrarotto
- the Department of Thoracic/Head and Neck Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston
| | - Michael E Kupferman
- Department of Head and Neck Surgery, the University of Texas MD Anderson Cancer Center, Houston
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, the University of Texas MD Anderson Cancer Center, Houston
| | - Gary B Gunn
- the Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston
| | - Shirley Y Su
- Department of Head and Neck Surgery, the University of Texas MD Anderson Cancer Center, Houston
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2
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Elhalawani H, Lin TA, Volpe S, Mohamed ASR, White AL, Zafereo J, Wong AJ, Berends JE, AboHashem S, Williams B, Aymard JM, Kanwar A, Perni S, Rock CD, Cooksey L, Campbell S, Yang P, Nguyen K, Ger RB, Cardenas CE, Fave XJ, Sansone C, Piantadosi G, Marrone S, Liu R, Huang C, Yu K, Li T, Yu Y, Zhang Y, Zhu H, Morris JS, Baladandayuthapani V, Shumway JW, Ghosh A, Pöhlmann A, Phoulady HA, Goyal V, Canahuate G, Marai GE, Vock D, Lai SY, Mackin DS, Court LE, Freymann J, Farahani K, Kaplathy-Cramer J, Fuller CD. Machine Learning Applications in Head and Neck Radiation Oncology: Lessons From Open-Source Radiomics Challenges. Front Oncol 2018; 8:294. [PMID: 30175071 PMCID: PMC6107800 DOI: 10.3389/fonc.2018.00294] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 07/16/2018] [Indexed: 12/13/2022] Open
Abstract
Radiomics leverages existing image datasets to provide non-visible data extraction via image post-processing, with the aim of identifying prognostic, and predictive imaging features at a sub-region of interest level. However, the application of radiomics is hampered by several challenges such as lack of image acquisition/analysis method standardization, impeding generalizability. As of yet, radiomics remains intriguing, but not clinically validated. We aimed to test the feasibility of a non-custom-constructed platform for disseminating existing large, standardized databases across institutions for promoting radiomics studies. Hence, University of Texas MD Anderson Cancer Center organized two public radiomics challenges in head and neck radiation oncology domain. This was done in conjunction with MICCAI 2016 satellite symposium using Kaggle-in-Class, a machine-learning and predictive analytics platform. We drew on clinical data matched to radiomics data derived from diagnostic contrast-enhanced computed tomography (CECT) images in a dataset of 315 patients with oropharyngeal cancer. Contestants were tasked to develop models for (i) classifying patients according to their human papillomavirus status, or (ii) predicting local tumor recurrence, following radiotherapy. Data were split into training, and test sets. Seventeen teams from various professional domains participated in one or both of the challenges. This review paper was based on the contestants' feedback; provided by 8 contestants only (47%). Six contestants (75%) incorporated extracted radiomics features into their predictive model building, either alone (n = 5; 62.5%), as was the case with the winner of the "HPV" challenge, or in conjunction with matched clinical attributes (n = 2; 25%). Only 23% of contestants, notably, including the winner of the "local recurrence" challenge, built their model relying solely on clinical data. In addition to the value of the integration of machine learning into clinical decision-making, our experience sheds light on challenges in sharing and directing existing datasets toward clinical applications of radiomics, including hyper-dimensionality of the clinical/imaging data attributes. Our experience may help guide researchers to create a framework for sharing and reuse of already published data that we believe will ultimately accelerate the pace of clinical applications of radiomics; both in challenge or clinical settings.
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Affiliation(s)
- Hesham Elhalawani
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Timothy A. Lin
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Baylor College of Medicine, Houston, TX, United States
| | - Stefania Volpe
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Università degli Studi di Milano, Milan, Italy
| | - Abdallah S. R. Mohamed
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Clinical Oncology and Nuclear Medicine, Alexandria University, Alexandria, Egypt
| | - Aubrey L. White
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- McGovern Medical School, University of Texas, Houston, TX, United States
| | - James Zafereo
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- McGovern Medical School, University of Texas, Houston, TX, United States
| | - Andrew J. Wong
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- School of Medicine, The University of Texas Health Science Center San Antonio, San Antonio, TX, United States
| | - Joel E. Berends
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- School of Medicine, The University of Texas Health Science Center San Antonio, San Antonio, TX, United States
| | - Shady AboHashem
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Bowman Williams
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Furman University, Greenville, SC, United States
| | - Jeremy M. Aymard
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Abilene Christian University, Abilene, TX, United States
| | - Aasheesh Kanwar
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Radiation Oncology, Oregon Health and Science University, Portland, OR, United States
| | - Subha Perni
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Crosby D. Rock
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States
| | - Luke Cooksey
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Shauna Campbell
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH, United States
| | - Pei Yang
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Baylor College of Medicine, Houston, TX, United States
| | - Khahn Nguyen
- Colgate University, Hamilton City, CA, United States
| | - Rachel B. Ger
- Graduate School of Biomedical Sciences, MD Anderson Cancer Center, Houston, TX, United States
- Department of Radiation Physics, Graduate School of Biomedical Sciences, MD Anderson Cancer Center, Houston, TX, United States
| | - Carlos E. Cardenas
- Graduate School of Biomedical Sciences, MD Anderson Cancer Center, Houston, TX, United States
- Department of Radiation Physics, Graduate School of Biomedical Sciences, MD Anderson Cancer Center, Houston, TX, United States
| | - Xenia J. Fave
- Moores Cancer Center, University of California, La Jolla, San Diego, CA, United States
| | - Carlo Sansone
- Dipartimento di Ingegneria Elettrica e delle Tecnologie dell'Informazione, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - Gabriele Piantadosi
- Dipartimento di Ingegneria Elettrica e delle Tecnologie dell'Informazione, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - Stefano Marrone
- Dipartimento di Ingegneria Elettrica e delle Tecnologie dell'Informazione, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - Rongjie Liu
- Baylor College of Medicine, Houston, TX, United States
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Chao Huang
- Baylor College of Medicine, Houston, TX, United States
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kaixian Yu
- Baylor College of Medicine, Houston, TX, United States
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Tengfei Li
- Baylor College of Medicine, Houston, TX, United States
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Yang Yu
- Baylor College of Medicine, Houston, TX, United States
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Youyi Zhang
- Baylor College of Medicine, Houston, TX, United States
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Hongtu Zhu
- Baylor College of Medicine, Houston, TX, United States
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jeffrey S. Morris
- Baylor College of Medicine, Houston, TX, United States
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Veerabhadran Baladandayuthapani
- Baylor College of Medicine, Houston, TX, United States
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - John W. Shumway
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Alakonanda Ghosh
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Andrei Pöhlmann
- Fraunhofer-Institut für Fabrikbetrieb und Automatisierung (IFF), Magdeburg, Germany
| | - Hady A. Phoulady
- Department of Computer Science, University of Southern Maine, Portland, OR, United States
| | - Vibhas Goyal
- Indian Institute of Technology Hyderabad, Sangareddy, India
| | | | | | - David Vock
- Department of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Stephen Y. Lai
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Dennis S. Mackin
- Colgate University, Hamilton City, CA, United States
- Department of Radiation Physics, Graduate School of Biomedical Sciences, MD Anderson Cancer Center, Houston, TX, United States
| | - Laurence E. Court
- Colgate University, Hamilton City, CA, United States
- Department of Radiation Physics, Graduate School of Biomedical Sciences, MD Anderson Cancer Center, Houston, TX, United States
| | - John Freymann
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, United States
| | - Keyvan Farahani
- National Cancer Institute, Rockville, MD, United States
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Jayashree Kaplathy-Cramer
- Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging, MGH/Harvard Medical School, Boston, MA, United States
| | - Clifton D. Fuller
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Baylor College of Medicine, Houston, TX, United States
- Department of Radiation Physics, Graduate School of Biomedical Sciences, MD Anderson Cancer Center, Houston, TX, United States
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3
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Eraj SA, Jomaa MK, Rock CD, Mohamed ASR, Smith BD, Smith JB, Browne T, Cooksey LC, Williams B, Temple B, Preston KE, Aymard JM, Gross ND, Weber RS, Hessel AC, Ferrarotto R, Phan J, Sturgis EM, Hanna EY, Frank SJ, Morrison WH, Goepfert RP, Lai SY, Rosenthal DI, Mendoza TR, Cleeland CS, Hutcheson KA, Fuller CD, Garden AS, Brandon Gunn G. Correction to: Long-term patient reported outcomes following radiation therapy for oropharyngeal cancer: cross-sectional assessment of a prospective symptom survey in patients ≥65 years old. Radiat Oncol 2017; 12:186. [PMID: 29169353 PMCID: PMC5701383 DOI: 10.1186/s13014-017-0921-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - Salman A Eraj
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,School of Medicine, The University of Texas Health Science Center at Houston, McGovern School of Medicine, Houston, TX, USA
| | - Mona K Jomaa
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Crosby D Rock
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,School of Medicine, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX, USA
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Blaine D Smith
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,School of Medicine, The University of Texas Health Science Center at Houston, McGovern School of Medicine, Houston, TX, USA
| | - Joshua B Smith
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,School of Medicine, The University of Texas Health Science Center at Houston, McGovern School of Medicine, Houston, TX, USA
| | - Theodora Browne
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Luke C Cooksey
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Abilene Christian University, Abilene, TX, USA
| | - Bowman Williams
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Brandi Temple
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Abilene Christian University, Abilene, TX, USA
| | - Kathryn E Preston
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Abilene Christian University, Abilene, TX, USA
| | - Jeremy M Aymard
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Abilene Christian University, Abilene, TX, USA
| | - Neil D Gross
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amy C Hessel
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Renata Ferrarotto
- Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jack Phan
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Erich M Sturgis
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Steven J Frank
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - William H Morrison
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David I Rosenthal
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Tito R Mendoza
- Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charles S Cleeland
- Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kate A Hutcheson
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Clifton D Fuller
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Medical Physics Program, The University of Texas Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Adam S Garden
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - G Brandon Gunn
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA. .,Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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4
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Eraj SA, Jomaa MK, Rock CD, Mohamed ASR, Smith BD, Smith JB, Browne T, Cooksey LC, Williams B, Temple B, Preston KE, Aymard JM, Gross ND, Weber RS, Hessel AC, Ferrarotto R, Phan J, Sturgis EM, Hanna EY, Frank SJ, Morrison WH, Goepfert RP, Lai SY, Rosenthal DI, Mendoza TR, Cleeland CS, Hutcheson KA, Fuller CD, Garden AS, Gunn GB. Long-term patient reported outcomes following radiation therapy for oropharyngeal cancer: cross-sectional assessment of a prospective symptom survey in patients ≥65 years old. Radiat Oncol 2017; 12:150. [PMID: 28888224 PMCID: PMC5591495 DOI: 10.1186/s13014-017-0878-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 08/23/2017] [Indexed: 11/10/2022] Open
Abstract
Background Given the potential for older patients to experience exaggerated toxicity and symptoms, this study was performed to characterize patient reported outcomes in older patients following definitive radiation therapy (RT) for oropharyngeal cancer (OPC). Methods Cancer-free head and neck cancer survivors (>6 months since treatment completion) were eligible for participation in a questionnaire-based study. Participants completed the MD Anderson Symptom Inventory-Head and Neck module (MDASI-HN). Those patients ≥65 years old at treatment for OPC with definitive RT were included. Individual and overall symptom severity and clinical variables were analyzed. Results Of the 79 participants analyzed, 82% were male, 95% white, 41% T3/4 disease, 39% RT alone, 27% induction chemotherapy, 52% concurrent, and 18% both, and 96% IMRT. Median age at RT was 71 yrs. (range: 65–85); median time from RT to MDASI-HN was 46 mos. (2/3 > 24 mos.). The top 5 MDASI-HN items rated most severe in terms of mean (±SD) ratings (0–10 scale) were dry mouth (3.48 ± 2.95), taste (2.81 ± 3.29), swallowing (2.59 ± 2.96), mucus in mouth/throat (2.04 ± 2.68), and choking (1.30 ± 2.38) reported at moderate-severe levels (≥5) by 35, 29, 29, 18, and 13%, respectively. Thirty-nine % reported none (0) or no more than mild (1–4) symptoms across all 22 MDASI-HN symptoms items, and 38% had at least one item rated as severe (≥7). Hierarchical cluster analysis resulted in 3 patient groups: 1) ~65% with ranging from none to moderate symptom burden, 2) ~35% with moderate-severe ratings for a subset of classically RT-related symptoms (e.g. dry mouth, mucus, swallowing) and 3) 2 pts. with severe ratings of most items. Conclusions The overall long-term symptom burden seen in this older OPC cohort treated with modern standard therapy was largely favorable, yet a higher symptom group (~35%) with a distinct pattern of mostly local and classically RT-related symptoms was identified. Electronic supplementary material The online version of this article doi: (10.1186/s13014-017-0878-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Salman A Eraj
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,School of Medicine, The University of Texas Health Science Center at Houston, McGovern School of Medicine, Houston, TX, USA
| | - Mona K Jomaa
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Crosby D Rock
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,School of Medicine, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX, USA
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Blaine D Smith
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,School of Medicine, The University of Texas Health Science Center at Houston, McGovern School of Medicine, Houston, TX, USA
| | - Joshua B Smith
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,School of Medicine, The University of Texas Health Science Center at Houston, McGovern School of Medicine, Houston, TX, USA
| | - Theodora Browne
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Luke C Cooksey
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Abilene Christian University, Abilene, TX, USA
| | - Bowman Williams
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Brandi Temple
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Abilene Christian University, Abilene, TX, USA
| | - Kathryn E Preston
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Abilene Christian University, Abilene, TX, USA
| | - Jeremy M Aymard
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Abilene Christian University, Abilene, TX, USA
| | - Neil D Gross
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amy C Hessel
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Renata Ferrarotto
- Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jack Phan
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Erich M Sturgis
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Steven J Frank
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - William H Morrison
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David I Rosenthal
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Tito R Mendoza
- Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charles S Cleeland
- Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kate A Hutcheson
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Clifton D Fuller
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,Medical Physics Program, The University of Texas Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Adam S Garden
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - G Brandon Gunn
- Department of Radiation Oncology, Unit 97, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA. .,Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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