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

R L Geary1, C Gillham1, G McVey1

  • 1St Luke's Radiation Oncology Network, Dublin, Ireland.

Clinical Oncology (Royal College of Radiologists (Great Britain))
|December 18, 2024
PubMed
Summary
This summary is machine-generated.

Intensity-modulated radiotherapy (IMRT) offers limited quality-of-life (QOL) benefits over three-dimensional conformal radiotherapy (3DCRT) for locally advanced rectal cancer patients. Emotional functioning improved, but physical and social functioning declined in both groups during treatment.

Keywords:
3DCRTIMRTneoadjuvantquality of liferadiotherapyrectal cancer

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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.