E-poster Presentation 2014 World Cancer Congress

Quality of life (QoL) in patients with malignant dysphagia receiving radiotherapy alone versus chemoradiotherapy: An International randomized trial: TROG (03.01) NCIC CTG (ES2) (#1003)

Rebecca K.S. Wong 1 , Heather-Jane Au 2 , Keyue Ding 3 , Jennifer A Harvey 4 , Sonya stephens 5 , Christopher J O'Callaghan 3 , Andrew Kneebone 6 , Sam Ngan 7 , Iain Ward 8 , Rajashi Roy 9 , Thomas R Sullivan 5 , Tirath Nijjar 10 , Jim J Biagi 11 , Liam Mulroy 12 , Michael G Penniment 5
  1. Radiation Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada
  2. Cross Cancer Institute, Edmonton, Alberta, Canada
  3. NCIC Clinical Trials Group , Kingston, Ontario, Canada
  4. Princess Alexandra Hospital, Queensland, Australia
  5. Royal Adelaide Hospital, Adelaide, SA, Australi
  6. Royal North Shore Hospital, Sydney, Australia
  7. Peter MacCallum Cancer Center, Melbourne, Australia
  8. Christchurch Hospital, Christchurch, New Zealand
  9. Castle Hill Hospital, Hull, United Kingdom
  10. Cross Cancer Institute, Edmonton, Canada
  11. Cancer Center of Southeastern Ontario , Kingston, Ontario, Canada
  12. QEII Health Science Center, Halifax, Nova Scotia, Canada


To describe the effect on QoL when CT was added to palliative RT in patients (pts) with incurable esophageal cancer.

Methods: 220 pts with malignant dysphagia were randomized to receive RT (30-35Gy in 10-15 fr)(n=109) ± concomitant 5FU and cisplatin x1 cycle. The primary outcome was dysphagia relief. QoL was evaluated using EORTC QLQ30/OES18 at baseline, wk 9, 13 and mthly x1yr. Group mean scores were compared between arms using Wilcoxon Rank-Sum test. Proportion of pts with improved, stable or worsened QoL (≥10 point change at any time compared with baseline) using chi square and MH chi-square test (for trend) while time to dysphagia improvement was compared using K-M estimates.

Results: QoL compliance ranged from 77% (169/220) at baseline to 62% (36/58) at mth12 and was similar between groups. Baseline mean scores were equivalent between arms with the exception of physical [79 (SD19) CRT vs. 83.84 (SD19) RT; p=0.016] and role domains [61 (SD34) CRT vs. 72 (SD32) RT; p = 0.01].

There was no significant difference in QoL between arms. The proportion of pts with improvement in the dysphagia domain was 50% CRT vs 64% RT (ns) while the time to improvement was 2.6m CRT vs 2.3m RT (ns). Similarly, eating domain was improved in 68% CRT and 74% RT (ns). Global QoL was 64% in both arms.

Other symptom domains/items that were improved in >50% of pts include pain (62%), and appetite (52%). Functional domain improvements ranged from 41% Emotional, 39% Role, 38% Social, 28% Cognitive to 18% Physical (average of scores in both arms).  

Conclusion: QoL data showed improvement in domains associated with nutritional intake for 50-70% of pts depending on the symptom measured. This was accompanied by moderate improvement in functional domains. No significant benefit was observed when CT was added to RT alone.