Quality-of-Life Analysis of a Phase II Randomised Controlled Trial Comparing Three-Dimensional Conformal Radiotherapy...

Area of Science:

• Radiation Oncology
• Gastrointestinal Oncology
• Clinical Trials

Background:

• Neoadjuvant radiotherapy is standard for locally advanced rectal cancer.
• Three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) are common techniques.
• Comparing quality-of-life (QOL) outcomes between these techniques is crucial for patient care.

Purpose of the Study:

• To compare QOL outcomes between 3DCRT and IMRT in patients with locally advanced rectal cancer receiving neoadjuvant chemoradiotherapy.
• To evaluate the impact of different radiotherapy planning techniques on patient well-being.

Main Methods:

• A phase II randomized trial involving 94 patients with locally advanced rectal cancer.
• Patients received neoadjuvant chemoradiotherapy (50.4 Gy) with fluorouracil or capecitabine.
• Random allocation to either 3DCRT or IMRT planning.
• QOL assessed using EORTC QLQ-C30 and QLQ-CR29 at baseline, during, and six months post-radiotherapy.
• Analysis of covariance adjusted for baseline scores to compare QOL between arms.

Main Results:

• The trial was terminated early due to futility regarding the primary outcome (acute gastrointestinal toxicity).
• Overall, emotional functioning improved, while physical, role, and social functioning declined from baseline in both groups.
• During the final week of radiotherapy, the IMRT group showed significantly better adjusted mean physical functioning (p=0.04) and role functioning (p=0.01) scores compared to the 3DCRT group.

Conclusions:

• Intensity-modulated radiotherapy (IMRT) demonstrates limited advantages in quality-of-life (QOL) compared to three-dimensional conformal radiotherapy (3DCRT) for patients with locally advanced rectal cancer.
• While some functional aspects showed transient benefits with IMRT, overall QOL impacts require further investigation in larger trials.