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T.M. Roth



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    P2.11 - Poster Session/ Palliative and Supportive Care (ID 230)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Palliative and Supportive Care
    • Presentations: 1
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      P2.11-008 - Association between Heart/Lung Dosimetric Parameters and Subsequent Changes in Quality of Life in Patients Receiving Thoracic Radiotherapy (ID 2549)

      09:30 - 09:30  |  Author(s): T.M. Roth

      • Abstract
      • Slides

      Background:
      Thoracic radiotherapy can negatively affect cardiopulmonary function. We herein report on a prospective assessment of the association between heart/lung dosimetric parameters and subsequent changes in the quality of life (QOL) in patients receiving thoracic radiotherapy.

      Methods:
      Patients about to initiate a course of 3D-planned external beam RT for tumors in/around the thorax were prospectively studied as part of an IRB-approved clinical study. Written informed consent was obtained. Patients had assessments of cardiopulmonary QOL pre-RT and serially post-RT (e.g. 1.5, 3, 6, 12... months post-RT) using the Functional Assessment of cancer Therapy-Lung (FACT-L) questionnaire. An association between a variety of dosimetric parameters for the heart and lungs (e.g. mean dose, Vx) and changes in pulmonary QOL (e.g. declines in QOL; pre-RT minus post-RT values) were assessed using univariate and multivariate techniques.

      Results:
      The data from 24 patients treated between 2009-2013 and with evaluable QOL were studied. Their demographics are as follows: median age 68 (range 48-87), 46% male, 92% white, 98% primary tumor from lung, 70% stage III or IV, 50% current or former smokers, 67% having no coexisting lung or heart disease before, 42% also receiving chemotherapy. For the overall group, there were no statistically significant differences between the pre-RT value (QOL score 80.6) and any of the post-RT time points (QOL scores 79.9, 79.9 and 76.3 at 1.5, 3 and 6 months post-RT, respectively). On a per-patient basis, there were no significant associations between any of the lung or heart dosimetric parameters and subsequent declines in QOL, though there was a non-significant trend towards greater declines in QOL with larger lung doses (e.g. mean, V20 and 30). There were no similar trends seen with the heart-based dosimetric parameters. When limiting the analysis to patients whose QOL score declined post-RT, there was a positive correlation between the degree of decline and the V30 and V40 of heart (p<0.05). Among patients with lung cancer, the degree of decline in QOL was associated with the heart V20, V30, V40 (p<0.05).

      Conclusion:
      There are no significant associations seen between lung and heart dosimetric parameters and subsequent declines in QOL. Additional analyses involving a larger number of patients are needed to better define predictors of RT-associated declines in QOL. (Supported in part by National Institutes of Health Grant CA69579 , a grant from the Lance Armstrong Foundation)

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