PMID- 32073955
OWN - NLM
STAT- MEDLINE
DCOM- 20210129
LR  - 20210521
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 38
IP  - 15
DP  - 2020 May 20
TI  - Improvement in Patient-Reported Outcomes With Intensity-Modulated Radiotherapy 
      (RT) Compared With Standard RT: A Report From the NRG Oncology RTOG 1203 Study.
PG  - 1685-1692
LID - 10.1200/JCO.19.02381 [doi]
AB  - PURPOSE: In oncology trials, the National Cancer Institute Common Terminology 
      Criteria for Adverse Events (CTCAE) is the standard tool for reporting adverse 
      events (AEs), but it may underreport symptoms experienced by patients. This 
      analysis of the NRG Oncology RTOG 1203 compared symptom reporting by patients and 
      clinicians during radiotherapy (RT). PATIENTS AND METHODS: Patients with cervical 
      or endometrial cancer requiring postoperative RT were randomly assigned to 
      standard 4-field RT or intensity-modulated RT (IMRT). Patients completed the 
      6-item patient-reported outcomes version of the CTCAE (PRO-CTCAE) for GI toxicity 
      assessing abdominal pain, diarrhea, and fecal incontinence at various time 
      points. Patients reported symptoms on a 5-point scale. Clinicians recorded these 
      AEs as CTCAE grades 1 to 5. Clinician- and patient-reported AEs were compared 
      using McNemar's test for rates > 0%. RESULTS: Of 278 eligible patients, 234 
      consented and completed the PRO-CTCAE. Patients reported high-grade abdominal 
      pain 19.1% (P < .0001), high-grade diarrhea 38.5% (P < .0001), and fecal 
      incontinence 6.8% more frequently than clinicians. Similar effects were seen 
      between grade >/= 1 CTCAE toxicity and any-grade patient-reported toxicity. 
      Between-arm comparison of patient-reported high-grade AEs revealed that at 5 
      weeks of RT, patients who received IMRT experienced fewer GI AEs than patients 
      who received 4-field pelvic RT with regard to frequency of diarrhea (18.2% 
      difference; P = .01), frequency of fecal incontinence (8.2% difference; P = .01), 
      and interference of fecal incontinence (8.5% difference; P = .04). CONCLUSION: 
      Patient-reported AEs showed a reduction in symptoms with IMRT compared with 
      standard RT, whereas clinician-reported AEs revealed no difference. Clinicians 
      also underreported symptomatic GI AEs compared with patients. This suggests that 
      patient-reported symptomatic AEs are important to assess in this disease setting.
FAU - Yeung, Anamaria R
AU  - Yeung AR
AD  - University of Florida, Gainesville, FL.
FAU - Pugh, Stephanie L
AU  - Pugh SL
AD  - NRG Oncology Statistics and Data Management Center, Philadelphia, PA.
FAU - Klopp, Ann H
AU  - Klopp AH
AD  - MD Anderson Cancer Center, Houston, TX.
FAU - Gil, Karen M
AU  - Gil KM
AD  - Summa Health System, Akron, OH.
FAU - Wenzel, Lari
AU  - Wenzel L
AD  - University of California Irvine, Irvine, CA.
FAU - Westin, Shannon N
AU  - Westin SN
AD  - MD Anderson Cancer Center, Houston, TX.
FAU - Gaffney, David K
AU  - Gaffney DK
AD  - Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.
FAU - Small, William Jr
AU  - Small W Jr
AD  - Loyola University Chicago, Chicago, IL.
FAU - Thompson, Spencer
AU  - Thompson S
AD  - University of Oklahoma Health Sciences Center, Oklahoma City, OK.
FAU - Doncals, Desiree E
AU  - Doncals DE
AD  - Cooper Cancer Center, Summa Akron City Hospital, Akron, OH.
FAU - Cantuaria, Guilherme H C
AU  - Cantuaria GHC
AD  - Northside Hospital, Atlanta, GA.
FAU - Yaremko, Brian P
AU  - Yaremko BP
AD  - London Regional Cancer Program, London, United Kingdom.
FAU - Chang, Amy
AU  - Chang A
AD  - Pamela Youde Nethersole Eastern Hospital, Hong Kong, Special Administrative 
      Region, People's Republic of China.
FAU - Kundapur, Vijayananda
AU  - Kundapur V
AD  - Saskatoon Cancer Centre, Saskatoon, Saskatchewan, Canada.
FAU - Mohan, Dasarahally S
AU  - Mohan DS
AD  - Kaiser Permanente Cancer Treatment Center, South San Francisco, CA.
FAU - Haas, Michael L
AU  - Haas ML
AD  - Reading Hospital, Reading, PA.
FAU - Kim, Yong Bae
AU  - Kim YB
AD  - Severance Hospital, Yonsei University Health System, Seoul, South Korea.
FAU - Ferguson, Catherine L
AU  - Ferguson CL
AD  - Georgia Regents University, Augusta, GA.
FAU - Deshmukh, Snehal
AU  - Deshmukh S
AD  - NRG Oncology Statistics and Data Management Center, Philadelphia, PA.
FAU - Bruner, Deborah W
AU  - Bruner DW
AD  - Emory University, Atlanta, GA.
FAU - Kachnic, Lisa A
AU  - Kachnic LA
AD  - Vanderbilt University School of Medicine, Nashville, TN.
LA  - eng
GR  - U10 CA180868/CA/NCI NIH HHS/United States
GR  - UG1 CA189867/CA/NCI NIH HHS/United States
GR  - U24 CA081647/CA/NCI NIH HHS/United States
GR  - U10 CA037422/CA/NCI NIH HHS/United States
GR  - U10 CA021661/CA/NCI NIH HHS/United States
GR  - U24 CA180803/CA/NCI NIH HHS/United States
GR  - U10 CA180822/CA/NCI NIH HHS/United States
PT  - Clinical Trial, Phase III
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20200219
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
CIN - Int J Radiat Oncol Biol Phys. 2020 Nov 15;108(4):839-845. PMID: 33069345
MH  - Female
MH  - Humans
MH  - Male
MH  - *Patient Reported Outcome Measures
MH  - Radiotherapy, Intensity-Modulated/*methods
PMC - PMC7238486
EDAT- 2020/02/20 06:00
MHDA- 2021/01/30 06:00
PMCR- 2021/05/20
CRDT- 2020/02/20 06:00
PHST- 2020/02/20 06:00 [pubmed]
PHST- 2021/01/30 06:00 [medline]
PHST- 2020/02/20 06:00 [entrez]
PHST- 2021/05/20 00:00 [pmc-release]
AID - 1902381 [pii]
AID - 10.1200/JCO.19.02381 [doi]
PST - ppublish
SO  - J Clin Oncol. 2020 May 20;38(15):1685-1692. doi: 10.1200/JCO.19.02381. Epub 2020 
      Feb 19.