ESTRO 2021 Abstract Book

S107

ESTRO 2021

Award lecture: Jens Overgaard Legacy Award

SP-0175 Towards evidence-based radiation oncology H. Langendijk The Netherlands

Abstract not available

Proffered papers: Proffered papers 8: Patient-reported outcome measures & quality of life

OC-0176 Risk factors for cognitive impairment in NSCLC: Secondary findings of the NVALT-11 study H. Zeng 1 , L. Hendriks 2 , W. Witlox 3 , H. Groen 4 , A. Dingemans 5 , J. Praag 6 , J. Belderbos 7 , R. Houben 1 , V. van der Noort 8 , D. De Ruysscher 1 1 GROW School for Oncology, Maastricht University Medical Centre+, Department of Radiation Oncology (Maastro), Maastricht, The Netherlands; 2 GROW - School for oncology and developmental biology, Maastricht University Medical Center+, Department of Pulmonary Diseases, Maastricht, The Netherlands; 3 GROW - School for oncology and developmental biology, Maastricht University Medical Center+, Maastricht, the Netherlands., Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht, The Netherlands; 4 University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands; 5 Erasmus MC Cancer Institute, Department of Pulmonary Diseases , Rotterdam, The Netherlands; 6 Erasmus MC Cancer Institute, Department of Radiation Oncology, Rotterdam, The Netherlands; 7 The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Radiation Oncology, Amsterdam, The Netherlands; 8 The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of biometrics, Amsterdam, The Netherlands Purpose or Objective To identify risk factors for cognitive impairment in patients with stage III non-small-cell lung cancer (NSCLC) in the randomized phase III NVALT-11 study (NCT01282437). Materials and Methods Stage III NSCLC patients without progression after chemoradiotherapy±surgery were randomized to prophylactic cranial irradiation (PCI) or observation. Quality of life (QOL) was assessed using the QLQ-C30 at baseline (before randomization), 1, 3, 6, 12, 24, and 36 months (m). Measurements within time windows of 2 weeks (for 1, 3, and 6 m) and 1m (for 12, 24, and 36 m) were allowed. A score <75 on the cognitive functioning scale of the QLQ-C30 was defined as cognitive impairment. Logistic regression analysis was performed to identify risk factors for impairment at each time point. Cox regression was performed for overall impairment post baseline. Results 174 patients (88 observation, 86 PCI) were randomized (median follow-up 60.2m). Five were excluded from this analysis because of craniotomy or psychosis history. QOL compliance rates ranged from 72.9-79.3% (Figure 1). The cognitive impairment rate increased from 21.6% at baseline to 42.9% at 36m (Figure 1). In total, 86 (52%) patients experienced impairment at least once (23 patients sustained, 18 reversed, 21 recurred, 6 reversed and recurred alternatively, and 18 were not evaluable because no reassessed QOL data after experienced cognitive decline were available). The univariate analysis showed that only smoking (OR=3.1, 95%CI 1.0-9.8, p=0.05) was significantly associated with baseline cognitive impairment (BCI). BCI was significantly associated with impairment at 1, 3, 6 and 12m (OR range: 3.1-9.4; p<0.05). Arm (OR=0.4, 95%CI 0.2-1.0, p=0.04) was significant at 3m. Age (OR=0.3, 95%CI 0.1-0.8, p=0.01) was significant at 12m. Body mass index (BMI) (OR=0.3, 95%CI 0.1-0.9, p=0.04) was significant at 24m. No variable was significant at 36m. For overall impairment, only BCI was significant (OR=12.8, 95%CI 3.6-45.4, p<0.001), which was confirmed in Cox regression (HR=3.6, 95%CI 2.1-6.1, p<0.001) (Table 1). These significant factors were included for multivariate analysis. Logistic regression model showed that no factor was an independent risk for BCI. BCI remained an independent risk factor for impairment at 1, 3, 6, and 12 m (OR range: 3.3-6.3, p<0.05). Arm (OR=0.3, 95%CI 0.1-0.9, p=0.03) was an independent risk factor at 3m and age (OR=0.2, 95%CI 0.1-0.8, p=0.02) was an independent risk factor at 12m. The sample size was too small to analyze 24m and 36m. BCI (OR=9.7, 95%CI 2.7-35.2, p=0.001) was the only independent risk factor for overall impairment and was confirmed in Cox regression model (HR=3.1, 95%CI 1.8-5.5, p<0.001) (Table 1).