Ontology highlight
ABSTRACT: Background
Adverse event reporting in oncology trials lacks temporal description. We propose a toxicity summarizing method that incorporates time.Methods
Patients recruited in a phase III trial (NCT01279135) that compared three-dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) for late toxicity in cervical cancer were included. Adverse events were reported using Common Terminology Criteria for Adverse Events (CTCAE) v3.0 and quality of life (QOL) with EORTC QLQ-C30 and CX24. A total of six symptoms with a related QOL question (diarrhoea, abdominal pain, anorexia, urinary incontinence, frequency and fatigue) were included. Month and severity score [MOSES= ∑ (CTCAE grade x proportionate time)] was calculated. Cumulative-MOSES (C-MOSES) was calculated by summating these 6 individual MOSES. QoL was categorized as "substantially symptomatic" or "not". Receiver operator curve analysis was performed to determine the MOSES cut off that predicts for substantial QOL symptoms. CTCAE and MOSES were tested for accurately categorizing QOL impact.Findings
In the construction dataset, 201/300 patients had symptoms. MOSES > 0.20 had higher accuracy than CTCAE for predicting impact on QOL related to diarrhoea (85% vs. 69%), anorexia (61% vs 51%), abdominal pain (71% vs. 57%), urinary incontinence (72% vs. 61%) and frequency (62% vs. 59%). C-MOSES > 0·70 correlated with reduction in role functioning and global QOL. While no difference was seen in CTCAE grade ≥1 Gastrointestinal (GI) toxicity between 3DCRT or IMRT arm, 3DCRT had higher C-MOSES than IMRT (HR=0.64;95% CI 0.41-0.99, p = 0.04).Interpretation
MOSES has higher accuracy than CTCAE in categorizing symptom specific and functional QOL. These results require further external validation.Funding
None.
SUBMITTER: Ranjan N
PROVIDER: S-EPMC9035686 | biostudies-literature | 2022 May
REPOSITORIES: biostudies-literature
Ranjan Nilesh N Chopra Supriya S Mangaj Akshay A Rane Pallavi P Charnalia Mayuri M Kannan Sadhana S Dora Tapas T Engineer Reena R Mahantshetty Umesh U Gurram Lavanya L Mittal Prachi P Ghosh Jaya J Maheshwari Amita A Shylasree T S TS Gupta Sudeep S Shrivastava S K SK
EClinicalMedicine 20220416
<h4>Background</h4>Adverse event reporting in oncology trials lacks temporal description. We propose a toxicity summarizing method that incorporates time.<h4>Methods</h4>Patients recruited in a phase III trial (NCT01279135) that compared three-dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) for late toxicity in cervical cancer were included. Adverse events were reported using Common Terminology Criteria for Adverse Events (CTCAE) v3.0 and quality of life (Q ...[more]