Quality of life and clinical outcomes in rectal cancer patients treated on a 1.5T MR-Linac within the MOMENTUM study

L. A. Daamen; J. M. Westerhoff; A. M. Couwenberg; P. M. Braam; H. Rütten; M. D. den Hartogh; J. P. Christodouleas; W. A. Hall; H. M. Verkooijen; M. P.W. Intven

doi:10.1016/j.ctro.2023.100721

Quality of life and clinical outcomes in rectal cancer patients treated on a 1.5T MR-Linac within the MOMENTUM study

L. A. Daamen, J. M. Westerhoff, A. M. Couwenberg, P. M. Braam, H. Rütten, M. D. den Hartogh, J. P. Christodouleas, W. A. Hall, H. M. Verkooijen, M. P.W. Intven^*

^*Corresponding author for this work

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Abstract

Background and purpose: This study assessed quality of life (QoL) and clinical outcomes in rectal cancer patients treated with magnetic resonance (MR) guided short-course radiation therapy (SCRT) on a 1.5 Tesla (T) MR-Linac during the first 12 months after treatment. Materials and methods: Rectal cancer patients treated with 25 Gy SCRT in five fractions with curative intent in the Netherlands (2019–2022) were identified in MOMENTUM (NCT04075305). Toxicity (CTCAE v5) and QoL (EORTC QLQ-C30 and -CR29) was primarily analyzed in patients without metastatic disease (M0) and no other therapies after SCRT. Patients who underwent tumor resection were censored from surgery. A generalized linear mixed-model was used to investigate clinically meaningful (≥10) and significant (P < 0.05) QoL changes. Clinical and pathological complete response (cCR and pCR) rates were calculated in patients in whom response was documented. Results: A total of 172 patients were included, of whom 112 patients were primarily analyzed. Acute and late radiation-induced high-grade toxicity were reported in one patient, respectively. CCR was observed in 8/64 patients (13 %), 14/37 patients (38 %) and 13/16 patients (91 %) at three, six and twelve months; pCR was observed in 3/69 (4 %) patients. After 12 months, diarrhea (mean difference [MD] −17.4 [95 % confidence interval [CI] −31.2 to −3.7]), blood and mucus in stool (MD −31.1 [95 % CI −46.4 to −15.8]), and anxiety (MD –22.4 [95 % CI −34.0 to −10.9]) were improved. Conclusion: High-field MR-guided SCRT for the treatment of patients with rectal cancer is associated with improved disease-related symptom management and functioning one year after treatment.

Original language	English
Article number	100721
Journal	Clinical and translational radiation oncology
Volume	45
DOIs	https://doi.org/10.1016/j.ctro.2023.100721
Publication status	Published - Mar 2024

Keywords

Clinical outcomes
MR-guided radiotherapy
Patient-reported outcomes
Quality of Life
Rectal cancer
Response assessment
Short-course radiation therapy
Toxicity

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Daamen, L. A., Westerhoff, J. M., Couwenberg, A. M., Braam, P. M., Rütten, H., den Hartogh, M. D., Christodouleas, J. P., Hall, W. A., Verkooijen, H. M., & Intven, M. P. W. (2024). Quality of life and clinical outcomes in rectal cancer patients treated on a 1.5T MR-Linac within the MOMENTUM study. Clinical and translational radiation oncology, 45, Article 100721. https://doi.org/10.1016/j.ctro.2023.100721

@article{5255936e9e3e4fcbb05b8623eee39f95,

title = "Quality of life and clinical outcomes in rectal cancer patients treated on a 1.5T MR-Linac within the MOMENTUM study",

abstract = "Background and purpose: This study assessed quality of life (QoL) and clinical outcomes in rectal cancer patients treated with magnetic resonance (MR) guided short-course radiation therapy (SCRT) on a 1.5 Tesla (T) MR-Linac during the first 12 months after treatment. Materials and methods: Rectal cancer patients treated with 25 Gy SCRT in five fractions with curative intent in the Netherlands (2019–2022) were identified in MOMENTUM (NCT04075305). Toxicity (CTCAE v5) and QoL (EORTC QLQ-C30 and -CR29) was primarily analyzed in patients without metastatic disease (M0) and no other therapies after SCRT. Patients who underwent tumor resection were censored from surgery. A generalized linear mixed-model was used to investigate clinically meaningful (≥10) and significant (P < 0.05) QoL changes. Clinical and pathological complete response (cCR and pCR) rates were calculated in patients in whom response was documented. Results: A total of 172 patients were included, of whom 112 patients were primarily analyzed. Acute and late radiation-induced high-grade toxicity were reported in one patient, respectively. CCR was observed in 8/64 patients (13 %), 14/37 patients (38 %) and 13/16 patients (91 %) at three, six and twelve months; pCR was observed in 3/69 (4 %) patients. After 12 months, diarrhea (mean difference [MD] −17.4 [95 % confidence interval [CI] −31.2 to −3.7]), blood and mucus in stool (MD −31.1 [95 % CI −46.4 to −15.8]), and anxiety (MD –22.4 [95 % CI −34.0 to −10.9]) were improved. Conclusion: High-field MR-guided SCRT for the treatment of patients with rectal cancer is associated with improved disease-related symptom management and functioning one year after treatment.",

keywords = "Clinical outcomes, MR-guided radiotherapy, Patient-reported outcomes, Quality of Life, Rectal cancer, Response assessment, Short-course radiation therapy, Toxicity",

author = "Daamen, {L. A.} and Westerhoff, {J. M.} and Couwenberg, {A. M.} and Braam, {P. M.} and H. R{\"u}tten and {den Hartogh}, {M. D.} and Christodouleas, {J. P.} and Hall, {W. A.} and Verkooijen, {H. M.} and Intven, {M. P.W.}",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s)",

year = "2024",

month = mar,

doi = "10.1016/j.ctro.2023.100721",

language = "English",

volume = "45",

}

Daamen, LA, Westerhoff, JM, Couwenberg, AM, Braam, PM, Rütten, H, den Hartogh, MD, Christodouleas, JP, Hall, WA, Verkooijen, HM & Intven, MPW 2024, 'Quality of life and clinical outcomes in rectal cancer patients treated on a 1.5T MR-Linac within the MOMENTUM study', Clinical and translational radiation oncology, vol. 45, 100721. https://doi.org/10.1016/j.ctro.2023.100721

TY - JOUR

T1 - Quality of life and clinical outcomes in rectal cancer patients treated on a 1.5T MR-Linac within the MOMENTUM study

AU - Daamen, L. A.

AU - Westerhoff, J. M.

AU - Couwenberg, A. M.

AU - Braam, P. M.

AU - Rütten, H.

AU - den Hartogh, M. D.

AU - Christodouleas, J. P.

AU - Hall, W. A.

AU - Verkooijen, H. M.

AU - Intven, M. P.W.

PY - 2024/3

Y1 - 2024/3

N2 - Background and purpose: This study assessed quality of life (QoL) and clinical outcomes in rectal cancer patients treated with magnetic resonance (MR) guided short-course radiation therapy (SCRT) on a 1.5 Tesla (T) MR-Linac during the first 12 months after treatment. Materials and methods: Rectal cancer patients treated with 25 Gy SCRT in five fractions with curative intent in the Netherlands (2019–2022) were identified in MOMENTUM (NCT04075305). Toxicity (CTCAE v5) and QoL (EORTC QLQ-C30 and -CR29) was primarily analyzed in patients without metastatic disease (M0) and no other therapies after SCRT. Patients who underwent tumor resection were censored from surgery. A generalized linear mixed-model was used to investigate clinically meaningful (≥10) and significant (P < 0.05) QoL changes. Clinical and pathological complete response (cCR and pCR) rates were calculated in patients in whom response was documented. Results: A total of 172 patients were included, of whom 112 patients were primarily analyzed. Acute and late radiation-induced high-grade toxicity were reported in one patient, respectively. CCR was observed in 8/64 patients (13 %), 14/37 patients (38 %) and 13/16 patients (91 %) at three, six and twelve months; pCR was observed in 3/69 (4 %) patients. After 12 months, diarrhea (mean difference [MD] −17.4 [95 % confidence interval [CI] −31.2 to −3.7]), blood and mucus in stool (MD −31.1 [95 % CI −46.4 to −15.8]), and anxiety (MD –22.4 [95 % CI −34.0 to −10.9]) were improved. Conclusion: High-field MR-guided SCRT for the treatment of patients with rectal cancer is associated with improved disease-related symptom management and functioning one year after treatment.

AB - Background and purpose: This study assessed quality of life (QoL) and clinical outcomes in rectal cancer patients treated with magnetic resonance (MR) guided short-course radiation therapy (SCRT) on a 1.5 Tesla (T) MR-Linac during the first 12 months after treatment. Materials and methods: Rectal cancer patients treated with 25 Gy SCRT in five fractions with curative intent in the Netherlands (2019–2022) were identified in MOMENTUM (NCT04075305). Toxicity (CTCAE v5) and QoL (EORTC QLQ-C30 and -CR29) was primarily analyzed in patients without metastatic disease (M0) and no other therapies after SCRT. Patients who underwent tumor resection were censored from surgery. A generalized linear mixed-model was used to investigate clinically meaningful (≥10) and significant (P < 0.05) QoL changes. Clinical and pathological complete response (cCR and pCR) rates were calculated in patients in whom response was documented. Results: A total of 172 patients were included, of whom 112 patients were primarily analyzed. Acute and late radiation-induced high-grade toxicity were reported in one patient, respectively. CCR was observed in 8/64 patients (13 %), 14/37 patients (38 %) and 13/16 patients (91 %) at three, six and twelve months; pCR was observed in 3/69 (4 %) patients. After 12 months, diarrhea (mean difference [MD] −17.4 [95 % confidence interval [CI] −31.2 to −3.7]), blood and mucus in stool (MD −31.1 [95 % CI −46.4 to −15.8]), and anxiety (MD –22.4 [95 % CI −34.0 to −10.9]) were improved. Conclusion: High-field MR-guided SCRT for the treatment of patients with rectal cancer is associated with improved disease-related symptom management and functioning one year after treatment.

KW - Clinical outcomes

KW - MR-guided radiotherapy

KW - Patient-reported outcomes

KW - Quality of Life

KW - Rectal cancer

KW - Response assessment

KW - Short-course radiation therapy

KW - Toxicity

UR - http://www.scopus.com/inward/record.url?scp=85182406191&partnerID=8YFLogxK

U2 - 10.1016/j.ctro.2023.100721

DO - 10.1016/j.ctro.2023.100721

M3 - Article

AN - SCOPUS:85182406191

SN - 2405-6308

VL - 45

JO - Clinical and translational radiation oncology

JF - Clinical and translational radiation oncology

M1 - 100721

ER -

Quality of life and clinical outcomes in rectal cancer patients treated on a 1.5T MR-Linac within the MOMENTUM study

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