Overview of health-related quality of life and toxicity of non-small cell lung cancer patients receiving curative-intent radiotherapy in a real-life setting (the REQUITE study)

Lotte Van der Weijst; Miguel E Aguado-Barrera; David Azria; Patrick Berkovic; Pierre Boisselier; Erik Briers; Renée Bultijnck; Patricia Calvo-Crespo; Jenny Chang-Claude; Ananya Choudhury; Gilles Defraene; Sylvian Demontois; Alison M Dunning; Rebecca M Elliott; Dawn Ennis; Corinne Faivre-Finn; Marzia Franceschini; Sara Gutiérrez-Enríquez; Carsten Herskind; Daniel S Higginson; Sarah L Kerns; Kerstie Johnson; Meritxell Mollà; Maarten Lambrecht; Mónica Ramos; Tiziana Rancati; Andreas Rimner; Barry S Rosenstein; Dirk De Ruysscher; Ahmed Salem; Claudia Sangalli; Petra Seibold; Paloma Sosa-Fajardo; Elena Sperk; Hilary Stobart; Holly Summersgill; Veerle Surmont; Paul Symonds; Begoña Taboada-Lorenzo; Christopher J Talbot; Riccardo Valdagni; Ana Vega; Liv Veldeman; Marlon R Veldwijk; Tim Ward; Adam Webb; Catharine M L West; Yolande Lievens; REQUITE consortium

doi:10.1016/j.lungcan.2022.03.010

Overview of health-related quality of life and toxicity of non-small cell lung cancer patients receiving curative-intent radiotherapy in a real-life setting (the REQUITE study)

Lotte Van der Weijst^*, Miguel E Aguado-Barrera, David Azria, Patrick Berkovic, Pierre Boisselier, Erik Briers, Renée Bultijnck, Patricia Calvo-Crespo, Jenny Chang-Claude, Ananya Choudhury, Gilles Defraene, Sylvian Demontois, Alison M Dunning, Rebecca M Elliott, Dawn Ennis, Corinne Faivre-Finn, Marzia Franceschini, Sara Gutiérrez-Enríquez, Carsten Herskind, Daniel S HigginsonSarah L Kerns, Kerstie Johnson, Meritxell Mollà, Maarten Lambrecht, Mónica Ramos, Tiziana Rancati, Andreas Rimner, Barry S Rosenstein, Dirk De Ruysscher, Ahmed Salem, Claudia Sangalli, Petra Seibold, Paloma Sosa-Fajardo, Elena Sperk, Hilary Stobart, Holly Summersgill, Veerle Surmont, Paul Symonds, Begoña Taboada-Lorenzo, Christopher J Talbot, Riccardo Valdagni, Ana Vega, Liv Veldeman, Marlon R Veldwijk, Tim Ward, Adam Webb, Catharine M L West, Yolande Lievens, REQUITE consortium

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVES: Radiotherapy-induced toxicity may negatively impact health-related quality of life (HRQoL). This report investigates the impact of curative-intent radiotherapy on HRQoL and toxicity in early stage and locally-advanced non-small cell lung cancer patients treated with radiotherapy or chemo-radiotherapy enrolled in the observational prospective REQUITE study.

MATERIALS AND METHODS: HRQoL was assessed using the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire up to 2 years post radiotherapy. Eleven toxicities were scored by clinicians using the Common Terminology Criteria for Adverse Events (CTCAE) version 4. Toxicity scores were calculated by subtracting baseline values. Mixed model analyses were applied to determine statistical significance (p ≤ 0.01). Meaningful clinical important differences (MCID) were determined for changes in HRQoL. Analysis was performed on the overall data, different radiotherapy techniques, multimodality treatments and disease stages.

RESULTS: Data of 510 patients were analysed. There was no significant change in HRQoL or its domains, except for deterioration in cognitive functioning (p = 0.01). Radiotherapy technique had no significant impact on HRQoL. The addition of chemotherapy was significantly associated with HRQoL over time (p <.001). Overall toxicity did not significantly change over time. Acute toxicities of radiation-dermatitis (p =.003), dysphagia (p =.002) and esophagitis (p <.001) peaked at 3 months and decreased thereafter. Pneumonitis initially deteriorated but improved significantly after 12 months (p =.011). A proportion of patients experienced meaningful clinically important improvements and deteriorations in overall HRQoL and its domains. In some patients, pre-treatment symptoms improved gradually.

CONCLUSIONS: While overall HRQoL and toxicity did not change over time, some patients improved, whereas others experienced acute radiotherapy-induced toxicities and deteriorated HRQoL, especially physical and cognitive functioning. Patient characteristics, more so than radiotherapy technique and treatment modality, impact post-radiotherapy toxicity and HRQoL outcomes. This stresses the importance of considering the potential impact of radiotherapy on individuals' HRQoL, symptoms and toxicity in treatment decision-making.

Original language	English
Pages (from-to)	228-241
Number of pages	14
Journal	Lung Cancer
Volume	166
Early online date	15 Mar 2022
DOIs	https://doi.org/10.1016/j.lungcan.2022.03.010
Publication status	Published - Apr 2022

Keywords

CLINICAL-PRACTICE
CLINICAL-TRIALS
CONCURRENT CHEMOTHERAPY
DOSE-ESCALATION
END-POINTS
EORTC QLQ-LC13
IMPACT
QLQ-C30
RADIATION-THERAPY IMRT
REPORTED OUTCOME MEASURES
SURVIVAL
TRIALS

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10.1016/j.lungcan.2022.03.010

Cite this

Van der Weijst, L., Aguado-Barrera, M. E., Azria, D., Berkovic, P., Boisselier, P., Briers, E., Bultijnck, R., Calvo-Crespo, P., Chang-Claude, J., Choudhury, A., Defraene, G., Demontois, S., Dunning, A. M., Elliott, R. M., Ennis, D., Faivre-Finn, C., Franceschini, M., Gutiérrez-Enríquez, S., Herskind, C., ... REQUITE consortium (2022). Overview of health-related quality of life and toxicity of non-small cell lung cancer patients receiving curative-intent radiotherapy in a real-life setting (the REQUITE study). Lung Cancer, 166, 228-241. https://doi.org/10.1016/j.lungcan.2022.03.010

@article{935cc14e917f49f5bb6bb516b1d9dfd4,

title = "Overview of health-related quality of life and toxicity of non-small cell lung cancer patients receiving curative-intent radiotherapy in a real-life setting (the REQUITE study)",

abstract = "OBJECTIVES: Radiotherapy-induced toxicity may negatively impact health-related quality of life (HRQoL). This report investigates the impact of curative-intent radiotherapy on HRQoL and toxicity in early stage and locally-advanced non-small cell lung cancer patients treated with radiotherapy or chemo-radiotherapy enrolled in the observational prospective REQUITE study.MATERIALS AND METHODS: HRQoL was assessed using the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire up to 2 years post radiotherapy. Eleven toxicities were scored by clinicians using the Common Terminology Criteria for Adverse Events (CTCAE) version 4. Toxicity scores were calculated by subtracting baseline values. Mixed model analyses were applied to determine statistical significance (p ≤ 0.01). Meaningful clinical important differences (MCID) were determined for changes in HRQoL. Analysis was performed on the overall data, different radiotherapy techniques, multimodality treatments and disease stages.RESULTS: Data of 510 patients were analysed. There was no significant change in HRQoL or its domains, except for deterioration in cognitive functioning (p = 0.01). Radiotherapy technique had no significant impact on HRQoL. The addition of chemotherapy was significantly associated with HRQoL over time (p <.001). Overall toxicity did not significantly change over time. Acute toxicities of radiation-dermatitis (p =.003), dysphagia (p =.002) and esophagitis (p <.001) peaked at 3 months and decreased thereafter. Pneumonitis initially deteriorated but improved significantly after 12 months (p =.011). A proportion of patients experienced meaningful clinically important improvements and deteriorations in overall HRQoL and its domains. In some patients, pre-treatment symptoms improved gradually.CONCLUSIONS: While overall HRQoL and toxicity did not change over time, some patients improved, whereas others experienced acute radiotherapy-induced toxicities and deteriorated HRQoL, especially physical and cognitive functioning. Patient characteristics, more so than radiotherapy technique and treatment modality, impact post-radiotherapy toxicity and HRQoL outcomes. This stresses the importance of considering the potential impact of radiotherapy on individuals' HRQoL, symptoms and toxicity in treatment decision-making.",

keywords = "CLINICAL-PRACTICE, CLINICAL-TRIALS, CONCURRENT CHEMOTHERAPY, DOSE-ESCALATION, END-POINTS, EORTC QLQ-LC13, IMPACT, QLQ-C30, RADIATION-THERAPY IMRT, REPORTED OUTCOME MEASURES, SURVIVAL, TRIALS",

author = "{Van der Weijst}, Lotte and Aguado-Barrera, {Miguel E} and David Azria and Patrick Berkovic and Pierre Boisselier and Erik Briers and Ren{\'e}e Bultijnck and Patricia Calvo-Crespo and Jenny Chang-Claude and Ananya Choudhury and Gilles Defraene and Sylvian Demontois and Dunning, {Alison M} and Elliott, {Rebecca M} and Dawn Ennis and Corinne Faivre-Finn and Marzia Franceschini and Sara Guti{\'e}rrez-Enr{\'i}quez and Carsten Herskind and Higginson, {Daniel S} and Kerns, {Sarah L} and Kerstie Johnson and Meritxell Moll{\`a} and Maarten Lambrecht and M{\'o}nica Ramos and Tiziana Rancati and Andreas Rimner and Rosenstein, {Barry S} and {De Ruysscher}, Dirk and Ahmed Salem and Claudia Sangalli and Petra Seibold and Paloma Sosa-Fajardo and Elena Sperk and Hilary Stobart and Holly Summersgill and Veerle Surmont and Paul Symonds and Bego{\~n}a Taboada-Lorenzo and Talbot, {Christopher J} and Riccardo Valdagni and Ana Vega and Liv Veldeman and Veldwijk, {Marlon R} and Tim Ward and Adam Webb and West, {Catharine M L} and Yolande Lievens and {REQUITE consortium}",

year = "2022",

month = apr,

doi = "10.1016/j.lungcan.2022.03.010",

language = "English",

volume = "166",

pages = "228--241",

journal = "Lung Cancer",

issn = "0169-5002",

publisher = "Elsevier Ireland Ltd",

}

Van der Weijst, L, Aguado-Barrera, ME, Azria, D, Berkovic, P, Boisselier, P, Briers, E, Bultijnck, R, Calvo-Crespo, P, Chang-Claude, J, Choudhury, A, Defraene, G, Demontois, S, Dunning, AM, Elliott, RM, Ennis, D, Faivre-Finn, C, Franceschini, M, Gutiérrez-Enríquez, S, Herskind, C, Higginson, DS, Kerns, SL, Johnson, K, Mollà, M, Lambrecht, M, Ramos, M, Rancati, T, Rimner, A, Rosenstein, BS, De Ruysscher, D, Salem, A, Sangalli, C, Seibold, P, Sosa-Fajardo, P, Sperk, E, Stobart, H, Summersgill, H, Surmont, V, Symonds, P, Taboada-Lorenzo, B, Talbot, CJ, Valdagni, R, Vega, A, Veldeman, L, Veldwijk, MR, Ward, T, Webb, A, West, CML, Lievens, Y & REQUITE consortium 2022, 'Overview of health-related quality of life and toxicity of non-small cell lung cancer patients receiving curative-intent radiotherapy in a real-life setting (the REQUITE study)', Lung Cancer, vol. 166, pp. 228-241. https://doi.org/10.1016/j.lungcan.2022.03.010

Overview of health-related quality of life and toxicity of non-small cell lung cancer patients receiving curative-intent radiotherapy in a real-life setting (the REQUITE study). / Van der Weijst, Lotte; Aguado-Barrera, Miguel E; Azria, David et al.
In: Lung Cancer, Vol. 166, 04.2022, p. 228-241.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Overview of health-related quality of life and toxicity of non-small cell lung cancer patients receiving curative-intent radiotherapy in a real-life setting (the REQUITE study)

AU - Van der Weijst, Lotte

AU - Aguado-Barrera, Miguel E

AU - Azria, David

AU - Berkovic, Patrick

AU - Boisselier, Pierre

AU - Briers, Erik

AU - Bultijnck, Renée

AU - Calvo-Crespo, Patricia

AU - Chang-Claude, Jenny

AU - Choudhury, Ananya

AU - Defraene, Gilles

AU - Demontois, Sylvian

AU - Dunning, Alison M

AU - Elliott, Rebecca M

AU - Ennis, Dawn

AU - Faivre-Finn, Corinne

AU - Franceschini, Marzia

AU - Gutiérrez-Enríquez, Sara

AU - Herskind, Carsten

AU - Higginson, Daniel S

AU - Kerns, Sarah L

AU - Johnson, Kerstie

AU - Mollà, Meritxell

AU - Lambrecht, Maarten

AU - Ramos, Mónica

AU - Rancati, Tiziana

AU - Rimner, Andreas

AU - Rosenstein, Barry S

AU - De Ruysscher, Dirk

AU - Salem, Ahmed

AU - Sangalli, Claudia

AU - Seibold, Petra

AU - Sosa-Fajardo, Paloma

AU - Sperk, Elena

AU - Stobart, Hilary

AU - Summersgill, Holly

AU - Surmont, Veerle

AU - Symonds, Paul

AU - Taboada-Lorenzo, Begoña

AU - Talbot, Christopher J

AU - Valdagni, Riccardo

AU - Vega, Ana

AU - Veldeman, Liv

AU - Veldwijk, Marlon R

AU - Ward, Tim

AU - Webb, Adam

AU - West, Catharine M L

AU - Lievens, Yolande

AU - REQUITE consortium

PY - 2022/4

Y1 - 2022/4

N2 - OBJECTIVES: Radiotherapy-induced toxicity may negatively impact health-related quality of life (HRQoL). This report investigates the impact of curative-intent radiotherapy on HRQoL and toxicity in early stage and locally-advanced non-small cell lung cancer patients treated with radiotherapy or chemo-radiotherapy enrolled in the observational prospective REQUITE study.MATERIALS AND METHODS: HRQoL was assessed using the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire up to 2 years post radiotherapy. Eleven toxicities were scored by clinicians using the Common Terminology Criteria for Adverse Events (CTCAE) version 4. Toxicity scores were calculated by subtracting baseline values. Mixed model analyses were applied to determine statistical significance (p ≤ 0.01). Meaningful clinical important differences (MCID) were determined for changes in HRQoL. Analysis was performed on the overall data, different radiotherapy techniques, multimodality treatments and disease stages.RESULTS: Data of 510 patients were analysed. There was no significant change in HRQoL or its domains, except for deterioration in cognitive functioning (p = 0.01). Radiotherapy technique had no significant impact on HRQoL. The addition of chemotherapy was significantly associated with HRQoL over time (p <.001). Overall toxicity did not significantly change over time. Acute toxicities of radiation-dermatitis (p =.003), dysphagia (p =.002) and esophagitis (p <.001) peaked at 3 months and decreased thereafter. Pneumonitis initially deteriorated but improved significantly after 12 months (p =.011). A proportion of patients experienced meaningful clinically important improvements and deteriorations in overall HRQoL and its domains. In some patients, pre-treatment symptoms improved gradually.CONCLUSIONS: While overall HRQoL and toxicity did not change over time, some patients improved, whereas others experienced acute radiotherapy-induced toxicities and deteriorated HRQoL, especially physical and cognitive functioning. Patient characteristics, more so than radiotherapy technique and treatment modality, impact post-radiotherapy toxicity and HRQoL outcomes. This stresses the importance of considering the potential impact of radiotherapy on individuals' HRQoL, symptoms and toxicity in treatment decision-making.

AB - OBJECTIVES: Radiotherapy-induced toxicity may negatively impact health-related quality of life (HRQoL). This report investigates the impact of curative-intent radiotherapy on HRQoL and toxicity in early stage and locally-advanced non-small cell lung cancer patients treated with radiotherapy or chemo-radiotherapy enrolled in the observational prospective REQUITE study.MATERIALS AND METHODS: HRQoL was assessed using the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire up to 2 years post radiotherapy. Eleven toxicities were scored by clinicians using the Common Terminology Criteria for Adverse Events (CTCAE) version 4. Toxicity scores were calculated by subtracting baseline values. Mixed model analyses were applied to determine statistical significance (p ≤ 0.01). Meaningful clinical important differences (MCID) were determined for changes in HRQoL. Analysis was performed on the overall data, different radiotherapy techniques, multimodality treatments and disease stages.RESULTS: Data of 510 patients were analysed. There was no significant change in HRQoL or its domains, except for deterioration in cognitive functioning (p = 0.01). Radiotherapy technique had no significant impact on HRQoL. The addition of chemotherapy was significantly associated with HRQoL over time (p <.001). Overall toxicity did not significantly change over time. Acute toxicities of radiation-dermatitis (p =.003), dysphagia (p =.002) and esophagitis (p <.001) peaked at 3 months and decreased thereafter. Pneumonitis initially deteriorated but improved significantly after 12 months (p =.011). A proportion of patients experienced meaningful clinically important improvements and deteriorations in overall HRQoL and its domains. In some patients, pre-treatment symptoms improved gradually.CONCLUSIONS: While overall HRQoL and toxicity did not change over time, some patients improved, whereas others experienced acute radiotherapy-induced toxicities and deteriorated HRQoL, especially physical and cognitive functioning. Patient characteristics, more so than radiotherapy technique and treatment modality, impact post-radiotherapy toxicity and HRQoL outcomes. This stresses the importance of considering the potential impact of radiotherapy on individuals' HRQoL, symptoms and toxicity in treatment decision-making.

KW - CLINICAL-PRACTICE

KW - CLINICAL-TRIALS

KW - CONCURRENT CHEMOTHERAPY

KW - DOSE-ESCALATION

KW - END-POINTS

KW - EORTC QLQ-LC13

KW - IMPACT

KW - QLQ-C30

KW - RADIATION-THERAPY IMRT

KW - REPORTED OUTCOME MEASURES

KW - SURVIVAL

KW - TRIALS

U2 - 10.1016/j.lungcan.2022.03.010

DO - 10.1016/j.lungcan.2022.03.010

M3 - Article

C2 - 35334417

SN - 0169-5002

VL - 166

SP - 228

EP - 241

JO - Lung Cancer

JF - Lung Cancer

ER -