Recursive partitioning analysis of pretreatment variables of 416 patients with locoregional esophageal cancer treated with definitive concomitant chemoradiotherapy on Intergroup and Radiation Therapy Oncology Group trials Journal Article


Authors: Thomas, C. R. Jr; Berkey, B. A.; Minsky, B. D.; Gaspar, L. E.; Herskovic, A.; Rich, T. A.; Gunderson, L. L.
Article Title: Recursive partitioning analysis of pretreatment variables of 416 patients with locoregional esophageal cancer treated with definitive concomitant chemoradiotherapy on Intergroup and Radiation Therapy Oncology Group trials
Abstract: Purpose To analyze the relative contributions of uniformly collected pretreatment patient- and tumor-related variables to survival and to identify the terminal nodes via recursive partitioning analysis (RPA) that could be used as a stratification variable for future Phase III trials. Methods and materials From two Intergroup trials (85-01, n = 130; and 94-05, n = 218) and one Radiation Therapy Oncology Group trial (92-07, n = 68), we identified 416 patients who were treated with definitive concomitant cisplatin and 5-FU-based chemoradiotherapy and analyzed their data for survival by RPA to define prognostic classes. The following pretreatment factors were evaluated: histologic type, age, weight loss, Karnofsky performance status, gender, race, T stage, tumor location, tumor size, N stage, and degree of dysphagia. The entire data set was considered as the initial node. The criterion for split points was the smallest p value less than unadjusted 0.05. Results Of the 416 patients, 336 (81%) were dead at the time of the analysis. The RPA identified only one significant split: pretreatment weight loss in the prior 6 months of <10% vs. ≥10%. After adjusting for multiple comparisons, no other split approached statistical significance. Conclusion Unlike our experience with malignant glioma, brain metastases, and locally advanced non-small-cell lung cancer, RPA failed to identify novel prognostic information that could be incorporated into the stratification scheme of future chemoradiotherapy trials for esophageal cancer. Furthermore, our analysis validated the percentage of weight loss as a stratification variable for esophageal cancer. © 2004 Elsevier Inc.
Keywords: adult; cancer survival; controlled study; aged; aged, 80 and over; middle aged; major clinical study; clinical trial; cancer localization; carcinoma, squamous cell; cisplatin; fluorouracil; cancer adjuvant therapy; cancer radiotherapy; combined modality therapy; cancer staging; adenocarcinoma; tumor localization; controlled clinical trial; tumor volume; antineoplastic combined chemotherapy protocols; radiotherapy; weight reduction; patient monitoring; oncology; histology; cause of death; dysphagia; statistical significance; evaluation; brain; tumors; sex difference; phase 3 clinical trial; race difference; age determination; esophagus carcinoma; esophageal neoplasms; brain metastases; cells; partition coefficient; clinical trials, phase iii; humans; prognosis; human; male; female; priority journal; article
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 58
Issue: 5
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2004-04-01
Start Page: 1405
End Page: 1410
Language: English
DOI: 10.1016/j.ijrobp.2003.09.022
PROVIDER: scopus
PUBMED: 15050316
DOI/URL:
Notes: Int. J. Radiat. Oncol. Biol. Phys. -- Cited By (since 1996):14 -- Export Date: 16 June 2014 -- CODEN: IOBPD -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Bruce Minsky
    306 Minsky