Data Collection to Assess Acute and Late Normal Tissue Sequelae in Proton Therapy for Adults
Summary
This study collects information on the side effects of proton therapy and detailed information on the proton therapy treatment plan itself. This may help researchers develop methods to predict the risk of side effects for future patients and learn the long-term benefit of proton therapy.
Detailed description
PRIMARY OBJECTIVES: I. To prospectively collect data on acute and late toxicities (including second malignant neoplasms) in patients treated with proton therapy. II. To collect and store the corresponding radiation dose distribution and imaging data in order to correlate normal tissue response with dose distribution. SECONDARY OBJECTIVES: I. To derive and refine dose-response relationships for normal tissue toxicity after proton therapy. II. To document and compare symptom burden weekly during treatment and twice a month for 3 months after therapy, using the M.D. Anderson Symptom Inventory (MDASI). OUTLINE: Patients undergoing standard of care proton therapy are assessed for toxicities weekly during proton treatment, then from 1 to 3 times up to 90 days from the start of treatment and annually thereafter. Patients also complete questionnaires over 15-20 minutes at baseline, weekly during treatment, and every 2 weeks during follow up for up to 3 months.
Arms & interventions
- OtherQuality-of-Life Assessment
Complete questionnaires
- OtherQuestionnaire Administration
Complete questionnaires
Outcome measures
Primary
Acute toxicities data in patients treated with proton therapy
Data will be collected from all organs receiving non-negligible proton dose during treatment. For each acute normal-tissue endpoint considered, analyses will be performed using the maximum toxicity score per patient within the 90-day follow-up. Upon analysis, the distribution of observed toxicity scores for each acute normal-tissue endpoint will be reported.
Time frame: Up to 90 days after end of treatment
Late toxicities data in patients treated with proton therapy
Data will be collected from all organs receiving non-negligible proton dose during treatment. For each late normal-tissue endpoint considered, analyses will be performed using censored time-to-event data corresponding to specified levels of injury (e.g. time to a specific grade \>= 2 late toxicity). The log-rank test will be used to compare event times in subgroups of patients with different dosimetric characteristics of treatment (e.g. portion of lung receiving \> 20 Gy: \<= 40% vs \> 40%). In addition, normal-tissue complication probability models will be fitted to data corresponding to incidence of a late endpoint within a specified time frame, with analysis limited to patients having the specified follow-up (e.g. incidence of grade \>= 2 late rectal bleeding within 2 years among patients followed for 2 years post-treatment).
Time frame: Starting 90 days or more after the end of radiotherapy
Dose-response relationships for normal tissue toxicity after proton therapy
Relevant dose-volume response models from the literature, such as the Lyman model, the parallel model, or the critical-element model will be fitted to the data when possible, and model parameter estimates reported. Confidence intervals for model parameter estimates will be derived using the profile-likelihood method.
Time frame: Up to 3 months after therapy
Secondary
Symptom burden
Time frame: Up to 3 months after therapy
Eligibility criteria
Study locations (1)
M D Anderson Cancer Center
Houston, Texas, 77030
References
- Gjyshi O, Xu T, Elhammali A, Boyce-Fappiano D, Chun SG, Gandhi S, Lee P, Chen AB, Lin SH, Chang JY, Tsao A, Gay CM, Zhu XR, Zhang X, Heymach JV, Fossella FV, Lu C, Nguyen QN, Liao Z. Toxicity and Survival After Intensity-Modulated Proton Therapy Versus Passive Scattering Proton Therapy for NSCLC. J Thorac Oncol. 2021 Feb;16(2):269-277. doi: 10.1016/j.jtho.2020.10.013. Epub 2020 Oct 22.(PubMed)