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ESMO-IASLC Best Abstracts (ID 61)
- Event: ELCC 2018
- Type: Best Abstract session
- Presentations: 1
109O - Health-related quality of life (QoL) after prophylactic cranial irradiation (PCI) vs no PCI for stage III NSCLC patients: Results from the NVALT-11/DLCRG-02 study (ID 273)
16:45 - 18:30 | Author(s): J. Belderbos
The NVALT-11/DLCRG-02 randomized phase III study compared PCI to observation after chemo-radiotherapy for stage III NSCLC and showed a significant decrease in time to develop symptomatic brain metastases in the PCI arm at the expense of more low-grade mostly neurological toxicity (HR 0.25 95% CI 0.11–0.58). We here report on the QoL.
EORTC QLQ-C30 and EuroQol 5D (EQ-5D) data measured before PCI and 3, 12, and 24 months thereafter were compared for both arms. Specifically, functional scales and global health status scores (QLQ-C30) as well as VAS and utility scores (EQ-5D) were analysed using non-parametric tests.
In total, 86 and 88 patients were included in the PCI and observational arm respectively, accumulating to 853 observations (five observations completely missing). Baseline QoL was similar between both arms, except for emotional (p = 0.025) and cognitive functioning (p = 0.039) which showed a significantly better score in the PCI arm. At three months, the observational arm scored significantly better on the EQ-VAS (median 70 vs 60, p = 0.017), while EQ-5D utility scores (Dutch tariff) were similar. At three months, QLQ-C30 showed that physical functioning, cognitive functioning, and global disease specific QoL were significantly better in the observational arm (median 83 vs 73, p = 0.003, median 100 vs 83, p = 0.006 and median 67 vs 67, p = 0.017). At later time-points, except for significantly better cognitive functioning at 24 months in the observational arm (median 83 vs 67, p = 0.017), no significantly different QoL (either QLQ-C30 or EQ-5D) was observed between the two arms.Table:Median scores of functional scales and global health status scores of QLQ-C30 and VAS and utility scores of EQ-5D
Median (PCI) Median (Observation) T0 T3 T12 T24 T0 T3 T12 T24 QLQ-C30 Physical 77 73 87 80 80 83 80 77 Role 67 67 67 67 67 67 67 67 Emotional 83 83 83 92 75 88 83 88 Cognitive 100 83 83 67 83 100 83 83 Social 83 83 100 83 83 83 83 92 Global QoL 67 67 67 67 67 67 67 67 EQ-5D Utility score 0.843 0.775 0.805 0.843 0.811 0.811 0.775 0.843 VAS score 65 60 70 75 70 70 69 70
In conclusion, despite substantially reducing the incidence of brain metastases in NSCLC patients, PCI impairs short term generic QoL as well as disease specific QoL. The impact on long term QoL is limited to problems concerning cognitive functioning only.
Clinical trial identification:
Legal entity responsible for the study:
Nederlandse Vereniging van Artsen voor Longziekten en Tuberculose (NVALT)
Has not received any funding
All authors have declared no conflicts of interest.
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