Advanced head and neck cancer in older adults: Results of a short course accelerated radiotherapy trial

Ferro, M.; Macchia, G.; Re, Alessia; Buwenge, M.; Ferro, M.; Boccardi, M.; Picardi, V.; Ianiro, A.; Arena, E.; Zamagni, Alice; Farina, E.; Cilla, Savino; Valentini, Vincenzo; Morganti, Alessio Giuseppe; Deodato, Francesco

doi:10.1016/j.jgo.2020.10.006

Cited by 12 publications

(25 citation statements)

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“…Ninety-three records were included to full text screening. Four studies were eligible for the primary objective and included in the narrative synthesis (20,(24)(25)(26). The most prevalent reasons for exclusion were unvalidated patient-reported outcomes, no use of patientreported outcomes, and no prospective study design (see Supplementary Tables 2 and 3).…”

Section: Screening Resultsmentioning

confidence: 99%

“…Three were prospective, nonrandomized phase II studies (20,24,26). One study was a prospective radiation dose-escalation study (25). Quality of life was the primary endpoint in only one study (26).…”

Section: Preliminary Synthesismentioning

confidence: 99%

“…One study assessed a cyclical regimen known as "Quad Shot" with four fractions in two consecutive days repeated every four weeks for up to three cycles (24). Another study assessed a similar protocol at higher radiation doses (25). The remaining two studies employed once daily consecutive or intermittent fractions (20,26).…”

Section: Preliminary Synthesismentioning

confidence: 99%

“…The remaining two studies employed once daily consecutive or intermittent fractions (20,26). Toxicity of grade three or higher was absent in two studies (24,25), moderate (e.g. mucositis 7%) in one study (26), and more pronounced (e.g.…”

Section: Preliminary Synthesismentioning

confidence: 99%

“…The studies employed different patient-reported outcome measures. One study used linear analogue scales for three domains and the visual analogue scale for the domain "pain" (25). The other studies used multiitem questionnaires (20,24,26).…”

Section: Preliminary Synthesismentioning

confidence: 99%

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Patient-Reported Outcomes Assessing the Impact of Palliative Radiotherapy on Quality of Life and Symptom Burden in Head and Neck Cancer Patients: A Systematic Review

et al. 2021

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Incurable head and neck cancer has a poor prognosis and impairs a patient’s health-related quality of life. Palliative radiotherapy may improve or stabilize health-related quality of life and symptoms, best measured by patient-reported outcomes. There is no systematic analysis if palliative radiotherapy for head and neck cancer improves or stabilizes health-related quality of life or symptoms as validly measured by patient-reported outcomes. Therefore, the primary objective of this systematic review (PROSPERO-ID: CRD42020166434) was to assess the effect of palliative radiotherapy for head and neck cancer on patient-reported outcomes. The secondary objective was to assess the rate and quality of use of patient-reported outcomes in relevant studies claiming a “palliative effect” of radiotherapy. The databases MEDLINE/PubMed, EMBASE, Cochrane CENTRAL, “ClinicalTrials.gov” were searched. Concerning the primary objective, four studies were eligible to assess the effectiveness of palliative radiotherapy as measured by patient-reported outcomes. A narrative synthesis suggests a favorable impact of palliative radiotherapy on health-related quality of life and symptom burden. The risk of bias, however, is considerable and the overall quality of evidence low. Concerning the secondary objective, over 90% of studies claiming a “palliative effect” of palliative radiotherapy did either not use patient-reported outcomes or did so by limited quality. In conclusion, implementation of patient-reported outcomes in studies assessing palliative radiotherapy for head and neck cancer should be fostered. Palliative radiotherapy remains an option for head and neck cancer patients, although more studies focusing on patient-reported outcomes are needed.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42020166434

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Section: Screening Resultsmentioning

confidence: 99%

Section: Preliminary Synthesismentioning

confidence: 99%

Section: Preliminary Synthesismentioning

confidence: 99%

Section: Preliminary Synthesismentioning

confidence: 99%

Section: Preliminary Synthesismentioning

confidence: 99%

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Patient-Reported Outcomes Assessing the Impact of Palliative Radiotherapy on Quality of Life and Symptom Burden in Head and Neck Cancer Patients: A Systematic Review

et al. 2021

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Use and Reporting of Patient-Reported Outcomes in Trials of Palliative Radiotherapy

et al. 2022

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ImportanceApproximately 50% of all patients with cancer have an indication for radiotherapy, and approximately 50% of radiotherapy is delivered with palliative intent, with the aim of alleviating symptoms. Symptoms are best assessed by patient-reported outcomes (PROs), yet their reliable interpretation requires adequate reporting in publications.ObjectiveTo investigate the use and reporting of PROs in clinical trials of palliative radiotherapy.Evidence ReviewThis preregistered systematic review searched PubMed/Medline, EMBASE, and the Cochrane Center Register of Controlled Trials for clinical trials of palliative radiotherapy published from 1990 to 2020. Key eligibility criteria were palliative setting, palliative radiotherapy as treatment modality, and clinical trial design (per National Institutes of Health definition). Two authors independently assessed eligibility. Trial characteristics were extracted and standard of PRO reporting was assessed in adherence to the Consolidated Standards of Reporting Trials (CONSORT) PRO extension. The association of the year of publication with the use of PROs was assessed by logistic regression. Factors associated with higher CONSORT-PRO adherence were analyzed by multiple regression. This study is reported following the PRISMA guidelines.FindingsAmong 7377 records screened, 225 published clinical trials representing 24 281 patients were eligible. Of these, 45 trials (20%) used a PRO as a primary end point and 71 trials (31%) used a PRO as a secondary end point. The most prevalent PRO measures were the Numeric Rating Scale/Visual Analogue Scale (38 trials), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 (32 trials), and trial-specific unvalidated measures (25 trials). A more recent year of publication was significantly associated with a higher chance of PROs as a secondary end point (odds ratio [OR], 1.04 [95% CI, 1.00-1.07]; P = .03) but not as primary end point. Adherence to CONSORT-PRO was poor or moderate for most items. Mean (SD) adherence to the extension adherence score was 46.2% (19.6%) for trials with PROs as primary end point and 31.8% (19.8%) for trials with PROs as a secondary end point. PROs as a primary end point (regression coefficient, 9.755 [95% CI, 2.270-17.240]; P = .01), brachytherapy as radiotherapy modality (regression coefficient, 16.795 [95% CI, 5.840-27.751]; P = .003), and larger sample size (regression coefficient, 0.028 [95% CI, 0.006-0.049]; P = .01) were significantly associated with better PRO reporting per extension adherence score.Conclusions and RelevanceIn this systematic review of palliative radiotherapy trials, the use and reporting of PROs had room for improvement for future trials, preferably with PROs as a primary end point.

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Treatment of elderly patients with head and neck cancer in an aging society: Focus on geriatric assessment and surgical treatment

Ishii,

Ohkoshi,

Katori

2024

Auris Nasus Larynx

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Advanced head and neck cancer in older adults: Results of a short course accelerated radiotherapy trial

Cited by 12 publications

References 32 publications

Patient-Reported Outcomes Assessing the Impact of Palliative Radiotherapy on Quality of Life and Symptom Burden in Head and Neck Cancer Patients: A Systematic Review

Patient-Reported Outcomes Assessing the Impact of Palliative Radiotherapy on Quality of Life and Symptom Burden in Head and Neck Cancer Patients: A Systematic Review

Use and Reporting of Patient-Reported Outcomes in Trials of Palliative Radiotherapy

Treatment of elderly patients with head and neck cancer in an aging society: Focus on geriatric assessment and surgical treatment

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