Best of ASCO - 2014 Annual Meeting

 

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Attend this session at the
2019 ASCO Annual Meeting!


Session: Health Services Research, Clinical Informatics, and Quality of Care

Type: Poster Session

Time: Saturday June 1, 1:15 PM to 4:15 PM

Location: Hall A


Session: Health Services Research, Clinical Informatics, and Quality of Care

Type: Poster Discussion Session

Time: Saturday June 1, 4:30 PM to 6:00 PM

Location: S102

Comparative effectiveness of proton therapy versus photon therapy as part of concurrent chemoradiotherapy for locally advanced cancer.

Sub-category:
Outcomes

Category:
Health Services Research, Clinical Informatics, and Quality of Care

Meeting:
2019 ASCO Annual Meeting

Abstract No:
6521

Poster Board Number:
Poster Discussion Session (Board #212)

Citation:
J Clin Oncol 37, 2019 (suppl; abstr 6521)

Author(s): Brian Christopher Baumann, Nandita Mitra, Joanna Harton, Ying Xiao, Andrzej Wojcieszynski, Peter Edward Gabriel, Haoyu Zhong, Huaizhi Geng, Abigail Doucette, Jenny J. Wei, Peter J. O'Dwyer, Justin E. Bekelman, James M. Metz; Washington University in St. Louis, Department of Radiation Oncology, St. Louis, MO; University of Pennsylvania Perelman School of Medicine, Department of Biostatistics and Epidemiology, Philadelphia, PA; University of Pennsylvania, Department of Radiation Oncology, Philadelphia, PA; Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; University of Pennsylvania Abramson Cancer Center, Division of Medical Oncology, Philadelphia, PA; University of Pennsylvania, Philadelphia, PA

Abstract Disclosures

Abstract:

Background: Concurrent chemo-radiotherapy is standard-of-care curative treatment for many cancers, but is associated with substantial morbidity. Proton therapy may increase the tolerability or effectiveness of concurrent chemo-radiotherapy by reducing radiation to normal tissues. Methods: We conducted a comparative effectiveness study of adult non-metastatic cancer patients treated with curative intent with proton chemo-radiotherapy vs. photon chemo-radiotherapy from 2011-2016 at the University of Pennsylvania. Re-irradiation and disease sites treated with photon-only therapy were excluded. Data on adverse events and survival was gathered prospectively. Primary endpoint was 90-day adverse events associated with unplanned hospitalizations (CTCAEv4 grade ≥3 adverse events). Secondary endpoints included decline in ECOG performance status during treatment, 90-day grade ≥2 adverse events, disease-free survival (DFS) and overall survival (OS). Modified Poisson regression models with inverse propensity score weighting were fit for both outcomes. Propensity scores were estimated using an ensemble machine-learning approach. Results: 1,483 patients were included (391 proton/1,092 photon). Proton patients were significantly older (median 66 vs. 61), had less favorable Charlson-Deyo comorbidity scores (median 3.0 vs. 2.0), and had lower integral radiation dose to tissues outside the target (p < 0.05 for all). Baseline toxicity and performance status were similar (p > 0.05). In propensity score weighted-analyses, proton chemo-radiotherapy was associated with significantly lower relative risk (RR) of 90-day grade ≥3 adverse events [11.5%(95%CI 8.3-14.7%) for protons; 27.6%(95%CI 24.9-30.2%) for photons; RR 0.31, 95%CI 0.15-0.66, p < 0.01]; 90-day grade ≥2 adverse events (RR 0.78, 95%CI 0.65-0.93, p < 0.01); and decline in performance status during treatment (RR 0.51, 95%CI 0.37-0.71, p < 0.01). There was no difference in DFS or OS. Conclusions: In adults with locally advanced cancer, proton chemo-radiotherapy was associated with significantly reduced acute adverse events causing unplanned hospitalizations with similar disease-free and overall survival.

 
Other Abstracts in this Sub-Category:

 

1. Longitudinal toxicity analysis with novel summary metrics of lenalidomide maintenance in follicular lymphoma in ECOG-ACRIN 2408.

Meeting: 2019 ASCO Annual Meeting Abstract No: 6511 First Author: Gita Thanarajasingam
Category: Health Services Research, Clinical Informatics, and Quality of Care - Outcomes

 

2. Clinical outcomes and cost-effectiveness of breast cancer screening for childhood cancer survivors treated with chest radiation: A comparative modeling study.

Meeting: 2019 ASCO Annual Meeting Abstract No: 6525 First Author: Jennifer Yeh
Category: Health Services Research, Clinical Informatics, and Quality of Care - Outcomes

 

3. Disparities in lung cancer outcomes for veterans with comorbid mental disorders.

Meeting: 2019 ASCO Annual Meeting Abstract No: 6577 First Author: Jacob E Berchuck
Category: Health Services Research, Clinical Informatics, and Quality of Care - Outcomes

 

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