MedicalResearch.com Interview with:
Benjamin Movsas, MD
Chairman of Radiation Oncology
Henry Ford Hospital
Medical Research: What is the background for this study? What are the main findings?
Dr. Movsas: The background is that a recent randomized lung cancer trial (RTOG 0617) showed a lower (rather than a higher) survival among the patients who received a higher dose of radiation (RT). This unexpected finding was puzzling as there were few differences in toxicity between the radiation dose arms noted by health care providers.
The main finding of the quality of life (QOL) analysis was that there was indeed a large difference in QOL as reported by the patients themselves (with lower QOL on the high RT dose arm at 3 months). Moreover, while this study was not randomized for RT technique, about half of the patients received intensity modulated RT (IMRT), a more sophisticated approach than the alternative (3D conformal RT), which can better protect normal tissues. Despite the fact that patients with larger tumors received IMRT, their self reported QOL one year later was significantly better (ie, much less decline in QOL) relative to patients who received 3D conformal RT. Finally, higher QOL at baseline significantly predicated for better survival.
Medical Research: What should clinicians and patients take away from your report?
Dr. Movsas: A key take away message is the fundamental importance of quality of life, which comes directly from our patients. Clinicians may underestimate the full impact of side effects of intensive treatments on their patients, so we need to ask our patients to tell us what they are experiencing from their perspective. Moreover, this study further supports the role of intensity modulated radiation therapy in lung cancer, which has been associated with lower toxicity, and now is also associated with significantly better quality of life (compared to 3D conformal radiation therapy).
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Movsas: We need to better understand the relationships between our radiation planning details and how these later impact the QOL for our patients. In this analysis, there were some intriguing associations in this regard which deserve further study.
Movsas B, Hu C, Sloan J, et al. Quality of Life Analysis of a Radiation Dose–Escalation Study of Patients With Non–Small-Cell Lung Cancer: A Secondary Analysis of the Radiation Therapy Oncology Group 0617 Randomized Clinical Trial. JAMA Oncol.Published online November 25, 2015. doi:10.1001/jamaoncol.2015.3969.
Benjamin Movsas (2015). Lung Cancer: Intensity Modulated Radiation Therapy Linked to Improved Quality of Life