Document Type
Article
Publication Date
2-1-2025
Abstract
PURPOSE: Novel methods generate functional images using image processing techniques combined with four-dimensional computed tomography (4DCT) data (4DCT-ventilation). 4DCT-ventilation was implemented in a phase II, multicenter functional avoidance clinical trial. The work compares functional avoidance patient-reported outcomes (PROs) against historical standards.
METHODS: Patients with locally advanced lung cancer undergoing curative-intent chemoradiation were accrued. 4DCT-ventilation imaging was generated and functional avoidance treatment plans created reduced dose to functional lung. PRO instruments included Functional Assessment of Cancer Therapy Lung questionnaire and accompanying subscales (including the Trial Outcome Index [TOI]), EuroQol-5 Dimension (EQ-5D), and EQ-Visual Analog Scale (EQ-VAS). The average change from baseline and percentage of clinically meaningful declines were calculated. We compared results against PROs from RTOG 0617 and PACIFIC trial data using Student t-tests and chi-square tests.
RESULTS: Fifty-nine patients completed baseline PRO surveys. The median age was 65 (44-86) years, non–small cell lung cancer comprised 83%, and median dose was 60 Gy in 30 fractions. The percent of patients with clinically meaningful decline in FACT-TOI at 12 months was 47.8% for RTOG 0617% and 26.8% for functional avoidance (P 5 .03). The functional avoidance cohort demonstrated a significantly (P 5 .012) higher change in EQ-VAS score at 12 months (9.9 6 3.3; average 6 SE) compared with the PACIFIC cohort (1.6 6 0.6).
CONCLUSION: The current work demonstrates improved PROs from a phase II functional avoidance trial in certain subscales (FACT-TOI and EQ-VAS) compared with PROs from seminal studies (RTOG 0617 and PACIFIC). The presented data support investigation of 4DCT functional avoidance in a phase III setting.
Recommended Citation
Poiset, Spencer; Lombardo, Joseph; Castillo, Edward; Castillo, Richard; Jones, Bernard; Miften, Moyed; Kavanagh, Brian; Dicker, Adam; Boyle, Cullen; Simone, Nicole; Movsas, Benjamin; Grills, Inga; Rusthoven, Chad; Vinogradskiy, Yevgeniy; and Wilson, Lydia, "Patient-Reported Outcomes: Comparing Functional Avoidance and Standard Thoracic Radiation Therapy in Lung Cancer" (2025). Department of Radiation Oncology Faculty Papers. Paper 202.
https://jdc.jefferson.edu/radoncfp/202
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
39903899
Language
English
Included in
Diagnosis Commons, Health Services Research Commons, Oncology Commons, Radiation Medicine Commons, Respiratory Tract Diseases Commons, Therapeutics Commons
Comments
This article is the author's final published version in JCO Clinical Cancer Informatics, Volume 9, February 2025, Article number e2400202.
The published version is available at https://doi.org/10.1200/CCI-24-00202.
Copyright © 2025 by American Society of Clinical Oncology