Early and late CTCAE and patient-reported outcomes following lung cancer radiotherapy: A sex-stratified descriptive analysis from the REQUITE cohort.
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Aguado-Barrera Miguel E, Calvo-Crespo Patricia, Taboada-Valladares Begoña, Gomez-Caamaño Antonio, Carracedo Angel, Azria David, Briers Erik, Chang-Claude Jenny, de Ruysscher Dirk, Defraene Gilles, Elliott Rebecca M, Faivre-Finn Corinne, Franceschini Marzia, Fuentes-Rios Olivia, Giraldo Alexandra, Giandini Tommaso, Gutiérrez-Enríquez Sara, Heumann Philipp, Higginson Daniel S, Johnson Kerstie, Lambrecht Maarten, Lievens Yolande, Mollà Meritxell, Rancati Tiziana, Rattay Tim, Ramos Mónica, Rosenstein Barry S, Seibold Petra, Sperk Elena, Stobart Hilary, Symonds Paul, Talbot Christopher J, Vandecasteele Katrien, Veldeman Liv, Ward Tim, Webb Adam, West Catharine M L, REQUITE consortium, Ana Vega
Аннотация
METHODS: We analysed longitudinal data from 530 lung cancer patients treated with radical radiotherapy (sequential or concurrent chemoradiotherapy, or stereotactic body radiation therapy [SBRT]) between 2014 and 2017 at 16 centres in Europe and the USA. Healthcare professionals prospectively recorded 21 pulmonary, oesophageal, neurological, cardiac, and skin adverse events using CTCAE v4.0. Patient-reported outcomes assessed symptoms, quality-of-life, fatigue, and physical activity. Adverse event incidence was stratified by sex, radiotherapy technique, chemotherapy administration, smoking status, and other clinical factors.
RESULTS: At 12 months, 309 patients were evaluable, with 151 having follow-up beyond one year. Pulmonary adverse events were most frequent (40% grade ≥ 2), mainly dyspnoea and cough. Women had higher rates of oesophagitis, and more frequently reported dysphagia, and chest wall pain, while men experienced a higher frequency of cardiac adverse events. Exploratory subgroup analyses identified significant sex-related differences in grade ≥ 3 pulmonary adverse events following SBRT and in overall grade ≥ 2 oesophageal adverse events among patients with clinical stage I-II and those aged >70 years. Patient-reported outcomes showed persistent fatigue and reduced physical activity, particularly in females. Symptom prevalence and severity varied by sex, age, treatment modality, smoking status, and clinical stage.
CONCLUSION: The REQUITE-Lung cohort provides prospectively collected real-world data on radiotherapy-related adverse events in lung cancer patients. This study describes patterns of adverse events and patient-reported outcomes according to sex, age, and treatment characteristics. These findings are hypothesis-generating and may support future validation in independent and pooled datasets.