First‐year quality of life assessment of an intra‐arterial (RADPLAT) versus intravenous chemoradiation phase III trial

Abstract

Background. We report the results of a multicenter randomized phase III study, assessing quality of life (QOL) in intra-arterial (IA) versus standard intravenous (IV) chemoradiation in advanced head and neck cancer.Methods. Two hundred seven patients with inoperable stage IV disease-152 men and 55 women; mean age, 55 yearswere included in this study. The patients were treated with standard radiotherapy with 4 weekly IA or 3 weekly IV cisplatin infusions. The QOL assessments carried out were EORTC-C30, H&N35, and trial-specific questionnaires.Results. Overall QOL deteriorated in all patients during treatment, is gradually improving over 1 year. IA patients showed significantly less nausea and vomiting at week 7 (p <.001). IV patients were significantly more fatigued (p <.006). At 1 year, no significant difference in tube feeding was found. Voice quality slightly exceeded the pretreatment values at 1 year. Forty-two of 62 employed patients returned to work.Conclusion. During treatment, significantly fewer problems with nausea and vomiting occurred in IA than in IV patients. Both groups showed improved voicing and oral intake during followup, often exceeding pretreatment values at 1 year.

Induction Chemotherapy and Cetuximab for Locally Advanced Squamous Cell Carcinoma of the Head and Neck: Results From a Phase II Prospective Trial

“…Encouraging functional outcomes were observed, with a 3% gastrostomy tube dependence rate (in a single living patient) and 8% aspiration rate, comparing favorably with existing literature, with reported rates of 15% to 30% [22][23][24] and up to 69%, 25,26 respectively. The basis for these favorable functional outcomes is unclear, and further studies are needed to determine the effects of sequential therapy, newer radiotherapy techniques, and use of a riskbased local therapy model on swallowing abilities.…”

Swallowing, nutrition and patient-rated functional outcomes at 6 months following two non-surgical treatments for T1–T3 oropharyngeal cancer

“…These results are similar to those previously reported where the majority of patients resumed soft diets, although reported ongoing diet restrictions at 12 months post-treatment [12,[15][16][17]. A number of reports describe "swallowing solids" [31] or "more or less normal oral feeding" [32] as positive outcomes for the CRT population without quantifying their function in more detail. Less information is known about the AFRT population diet tolerance post-treatment with initial data suggesting mild difficulty swallowing solids post-treatment [6].…”

Impact of Concurrent Chemoradiation on Quality of Life in Locally Advanced Head and Neck Cancers

“…15 We noticed an increase in nausea and vomiting in our study during treatment and post completion of treatment which gradually decreased over a period of 1month and still further 3months post completion of treatment but not reaching to pre-treatment levels. Ackerstaff et al 16 evaluated the quality of life of 207 patients with inoperable stage IV head and neck patients undergoing concurrent chemo-radiation and found that there was significant increase in nausea and vomiting on 7 th week assessment with IV cisplatin based chemotherapy which improved over a 3-month period post completion of treatment and almost reaching baseline at 12-months post therapy. 16 Pain was a major problem for patients in our study during treatment and on completion of treatment with major pain relief seen after 1 month, reaching baseline levels post 3 months of treatment.…”

“…Ackerstaff et al 16 evaluated the quality of life of 207 patients with inoperable stage IV head and neck patients undergoing concurrent chemo-radiation and found that there was significant increase in nausea and vomiting on 7 th week assessment with IV cisplatin based chemotherapy which improved over a 3-month period post completion of treatment and almost reaching baseline at 12-months post therapy. 16 Pain was a major problem for patients in our study during treatment and on completion of treatment with major pain relief seen after 1 month, reaching baseline levels post 3 months of treatment. Pain in our study was mainly caused by mucositis.…”

“…Ackerstaff et al 16 evaluated the quality of life of 207patients with inoperable stage IV head and neck patients undergoing concurrent chemo-radiation. In the same study of Ackerstaff et al, 16 he found that pain in the head and neck area was clearly present in pre-treatment period and increased during treatment and diminished over a course of 12-month follow-up.…”