| Title: |
Association of Radiotherapy Duration With Clinical Outcomes in Patients With Esophageal Cancer Treated in NRG Oncology Trials: A Secondary Analysis of NRG Oncology Randomized Clinical Trials |
| Authors: |
Hallemeier, Christopher L.; Moughan, Jennifer; Haddock, Michael G.; Herskovic, Arnold M.; Minsky, Bruce D.; Suntharalingam, Mohan; Zeitzer, Kenneth L.; Garg, Madhur K.; Greenwald, Bruce D.; Komaki, Ritsuko U.; Puckett, Lindsay L.; Kim, Hyun; Lloyd, Shane; Bush, David A.; Kim, Harold E.; Lad, Thomas E.; Meyer, Joshua E.; Okawara, Gordon S.; Raben, Adam; Schefter, Tracey E.; Barker, Jerry L.; Falkson, Carla I.; Videtic, Gregory M.M.; Jacob, Rojymon; Winter, Kathryn A.; Crane, Christopher H. |
| Source: |
Einstein Health Papers |
| Publisher Information: |
Jefferson Digital Commons |
| Publication Year: |
2023 |
| Collection: |
Jefferson Digital Commons (Thomas Jefferson University, Philadelphia) |
| Subject Terms: |
humans; male; female; middle aged; prospective studies; randomized controlled trials as topic; esophageal neoplasms; disease-free survival; progression-free survival; Medicine and Health Sciences; Oncology; Radiology |
| Description: |
IMPORTANCE: For many types of epithelial malignant neoplasms that are treated with definitive radiotherapy (RT), treatment prolongation and interruptions have an adverse effect on outcomes. OBJECTIVE: To analyze the association between RT duration and outcomes in patients with esophageal cancer who were treated with definitive chemoradiotherapy (CRT). DESIGN, SETTING, AND PARTICIPANTS: This study was an unplanned, post hoc secondary analysis of 3 prospective, multi-institutional phase 3 randomized clinical trials (Radiation Therapy Oncology Group [RTOG] 8501, RTOG 9405, and RTOG 0436) of the National Cancer Institute-sponsored NRG Oncology (formerly the National Surgical Adjuvant Breast and Bowel Project, RTOG, and Gynecologic Oncology Group). Enrolled patients with nonmetastatic esophageal cancer underwent definitive CRT in the trials between 1986 and 2013, with follow-up occurring through 2014. Data analyses were conducted between March 2022 to February 2023. EXPOSURES: Treatment groups in the trials used standard-dose RT (50 Gy) and concurrent chemotherapy. MAIN OUTCOMES AND MEASURES: The outcomes were local-regional failure (LRF), distant failure, disease-free survival (DFS), and overall survival (OS). Multivariable models were used to examine the associations between these outcomes and both RT duration and interruptions. Radiotherapy duration was analyzed as a dichotomized variable using an X-Tile software to choose a cut point and its median value as a cut point, as well as a continuous variable. RESULTS: The analysis included 509 patients (median [IQR] age, 64 [57-70] years; 418 males [82%]; and 376 White individuals [74%]). The median (IQR) follow-up was 4.01 (2.93-4.92) years for surviving patients. The median cut point of RT duration was 39 days or less in 271 patients (53%) vs more than 39 days in 238 patients (47%), and the X-Tile software cut point was 45 days or less in 446 patients (88%) vs more than 45 days in 63 patients (12%). Radiotherapy interruptions occurred in 207 patients (41%). Female ... |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://jdc.jefferson.edu/einsteinfp/8; https://jdc.jefferson.edu/context/einsteinfp/article/1005/viewcontent/hallemeier_2023_oi_230271_1681485563.7079__1_.pdf; https://jdc.jefferson.edu/context/einsteinfp/article/1005/filename/0/type/additional/viewcontent/Supplementary_Material_1.pdf; https://jdc.jefferson.edu/context/einsteinfp/article/1005/filename/1/type/additional/viewcontent/Supplementary_Material_2.pdf; https://jdc.jefferson.edu/context/einsteinfp/article/1005/filename/2/type/additional/viewcontent/Supplementary_Material_3.pdf; https://jdc.jefferson.edu/context/einsteinfp/article/1005/filename/3/type/additional/viewcontent/Supplementary_Material_4.pdf; https://jdc.jefferson.edu/context/einsteinfp/article/1005/filename/4/type/additional/viewcontent/Supplementary_Material_5.pdf |
| Availability: |
https://jdc.jefferson.edu/einsteinfp/8; https://jdc.jefferson.edu/context/einsteinfp/article/1005/viewcontent/hallemeier_2023_oi_230271_1681485563.7079__1_.pdf; https://jdc.jefferson.edu/context/einsteinfp/article/1005/filename/0/type/additional/viewcontent/Supplementary_Material_1.pdf; https://jdc.jefferson.edu/context/einsteinfp/article/1005/filename/1/type/additional/viewcontent/Supplementary_Material_2.pdf; https://jdc.jefferson.edu/context/einsteinfp/article/1005/filename/2/type/additional/viewcontent/Supplementary_Material_3.pdf; https://jdc.jefferson.edu/context/einsteinfp/article/1005/filename/3/type/additional/viewcontent/Supplementary_Material_4.pdf; https://jdc.jefferson.edu/context/einsteinfp/article/1005/filename/4/type/additional/viewcontent/Supplementary_Material_5.pdf |
| Rights: |
http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.44DBF324 |
| Database: |
BASE |