313 - Quality of Life (QOL) of Patients with Human Papillomavirus (HPV)-Associated Oropharyngeal Squamous Cell Carcinoma (OPSCC) in NRG-HN002

M. T. Truong¹, P. Torres-Saavedra², M. Gillison³, J. J. Caudell⁴, M. K. Gibson⁵, J. Waldron⁶, P. Xia⁷, C. H. Chung⁸, C. S. Kong⁹, M. Yao¹⁰, R. Jordan¹¹, R. M. Subramaniam¹², J. S. Lewin¹³, J. L. Geiger¹⁴, H. Kang¹⁵, D. M. Blakaj¹⁶, L. K. Mell¹⁷, J. Harris¹⁸, B. Movsas¹⁹, and S. S. Yom¹¹; ¹Department of Radiation Oncology, Boston Medical Center, Boston, MA, ²The American College of Radiology, Philadelphia, PA, ³The University of Texas MD Anderson Cancer Center, Houston, TX, ⁴H. Lee Moffitt Cancer Center and Research Institute, Department of Radiation Oncology, Tampa, FL, ⁵Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center, Nashville, TN, ⁶Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada, ⁷Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, ⁸H. Lee Moffitt Cancer Center, Tampa, FL, ⁹Department of Pathology, Stanford University, Stanford, CA, ¹⁰University Hospitals Cleveland Medical Center, Cleveland, OH, ¹¹University of California San Francisco, San Francisco, CA, ¹²University of Notre Dame, Sydney, Australia, ¹³MD Anderson Cancer Center, Houston, TX, ¹⁴Department of Hematology and Medical Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, ¹⁵University of California, San Francisco, CA, ¹⁶Department of Radiation Oncology, James Cancer Hospital, The Ohio State University, Columbus, OH, ¹⁷University of California San Diego, La Jolla, CA, ¹⁸American College of Radiology, Philadelphia, PA, ¹⁹Department of Radiation Oncology, Henry Ford Health, Detroit, MI

Purpose/Objective(s): To evaluate secondary QOL endpoints of patients with HPV-associated OPSCC receiving reduced-dose radiation. Materials/

Methods: NRG-HN002 was a phase II randomized trial in patients with p16-positive OPSCC receiving 60 Gy of intensity-modulated radiation therapy and cisplatin (IMRTC) over 6 weeks or IMRT alone over 5 weeks. The MD Anderson Dysphagia Inventory (MDADI), Performance Status Scale for Head and Neck Cancer Patients (PSS-HN), University of Washington Quality of Life Questionnaire, Version 4 (UW-QOL), and Work Status Questionnaire were collected at baseline, end of RT, 6, 12 and 24 months from end of RT. Multivariable linear mixed models were used to analyze MDADI and UW-QOL composite scores and mixed ordinal logistic models for PSS-HN and individual UW-QOL items (2-sided alpha=0.05).
Results: Completion rates were 86-93% at baseline (n=306) and 69-73% at 2 years. Most domains exhibited deterioration at the end of RT and improved scores 6, 12, and 24 months post-RT. UW-QOL anxiety scores were lower at baseline and end of RT, then improved at 6-24 months. UW-QOL shoulder function was decreased up to 6 months post-RT. All domains showed a statistically significant score difference over time (p<0.05). Except for PSS-HN public eating (p=0.03), UW-QOL swallowing (p=0.045), and mood (p=0.02), the arms were not significantly different for any domain over time. PSS-HN public eating scores were worse for IMRT than IMRTC at 24 months post-RT (OR=4.90, 95% CI [1.43-16.76]). UW-QOL swallowing (OR=0.45 [0.20-1.00]) and mood scores (OR=0.27 [0.13-0.58]) were better for IMRT at the end of RT. UW-QOL activity (OR=0.46 [0.27-0.78]) and recreation (OR=0.49 [0.29-0.80]) scores were better for IMRT over time. At 6 months post-RT, patients working full-time for IMRTC and IMRT were 45.4% vs. 52.2% (p=0.74).
Conclusion: Reduced dose radiation impairs QOL and swallowing-related QOL at the end of RT, with recovery at 6 months and onwards. PSS-HN public eating was worse for IMRT at 24 months post-RT. UW-QOL swallowing and mood were better for IMRT at the end of RT, and activity and recreation were better for IMRT over time.

Abstract 313 – Table 1

	PSS-HN (n=306)				UW-QOL (n=267)
Mean (SD)	Normalcy of Diet		Public Eating		Swallowing		Mood
Timepoint	IMRT	IMRTC	IMRT	IMRTC	IMRT	IMRTC	IMRT	IMRTC
Baseline	94.08 (16.83)	97.56 (12.22)	97.12 (12.70)	98.85 (8.12)	91.86 (16.08)	96.39 (10.34)	81.00 (22.32)	88.33 (14.83)
End of RT	41.03 (27.92)	36.64 (28.16)	59.78 (31.36)	56.88 (32.89)	51.39 (24.01)	46.34 (26.35)	68.22 (22.67)	60.82 (22.51)
6 months	88.38 (20.12)	90.53 (18.60)	93.30 (18.07)	94.64 (14.01)	81.83 (19.05)	83.83 (17.29)	82.83 (20.09)	85.26 (21.10)
12 months	90.00 (18.55)	94.43 (14.15)	94.91 (16.66)	96.31 (13.12)	85.02 (17.22)	89.58 (17.86)	87.63 (19.47)	90.32 (18.21)
24 months	92.90 (17.73)	95.79 (10.64)	92.02 (20.81)	97.90 (9.16)	81.80 (20.01)	86.99 (18.96)	88.89 (15.95)	90.05 (16.54)