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Quality‐adjusted survival analysis of Radiation Therapy Oncology Group (RTOG) 90‐03: Phase III randomized study comparing altered fractionation to standard fractionation radiotherapy for locally advanced head and neck squamous cell carcinoma
Author(s) -
Konski Andre A.,
Winter Kathryn,
Cole Bernard F.,
Ang KieKian,
Fu Karen K.
Publication year - 2009
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20949
Subject(s) - radiation therapy , medicine , fractionation , toxicity , dose fractionation , oncology , head and neck , head and neck squamous cell carcinoma , nuclear medicine , head and neck cancer , surgery , chemistry , organic chemistry
Background. To evaluate quality‐adjusted survival (QAS) of patients with locally advanced squamous cell carcinoma of the head and neck treated with 4 different radiation fractionation schedules. Methods. QAS was calculated using the quality‐adjusted time without toxicity or relapse (Q‐TWiST) methodology. Utilities (patient preferences for certain health states) were obtained by threshold analysis. Q‐TWiST therefore equaled TWiST + ([weight for toxicity] × [time spent in toxicity]) + ([weight for relapse] × [time spent in relapse]). Results. A statistically significant increase in QAS existed for patients treated with hyperfractionated radiotherapy compared with standard fractionated radiotherapy (SFX) with a toxicity utility ≥0.57 and relapse utility ≤0.72. No statistically significant difference was observed for patients treated with the other 2 fractionation schedules compared with SFX. Conclusion. Q‐TWiST analysis identified patient groups that would benefit from more aggressive therapy. Further investigation with patient‐generated utilities is needed. © 2008 Wiley Periodicals, Inc. Head Neck, 2009