Comorbidity and Karnofksy performance score are independent prognostic factors in @entity5 : an institutional analysis of XXXX treated on four RTOG studies. Radiation Therapy Oncology Group.

@entity1 @entity286 @entity5 @entity1149 @entity1349
PURPOSE: To determine the prognostic role of comorbidity in @entity5 ( @entity1149 ) treated definitively with radiotherapy alone. METHODS AND MATERIALS: A total of 112 @entity1 with clinical @entity5 (American Joint Commission on Cancer 1997) enrolled in four Radiation Therapy Oncology Group studies (83-11, 84-03, 84-07, and 88-08 nonchemotherapy arms) at a single institution were analyzed retrospectively for @entity1349 ( @entity1349 ) and comorbidity. Of the 112 @entity1 , 105 (94%) completed their assigned radiotherapy. The median assigned dose was 50.4 Gy to the lymphatics (range 45-50.4 Gy) and 70.2 Gy to the @entity5 (range 60-79.2 Gy). Comorbidity was rated retrospectively using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) and Charlson scales. Karnofsky performance scores (KPSs) and weight loss were prospectively recorded. Because only 8 @entity1 had a KPS of <70, these @entity1 were combined with @entity1 who had a KPS of 70. The @entity1349 of this group was compared with that of the @entity1 with better KPSs (>70). RESULTS: The median survival was 10.39 months (range 7.87-12.91). The 2-, 3-, and 5-year @entity1349 rate was 20.5%, 12.5%, and 7.1%, respectively. On univariate analysis, clinical stage (IIIA vs. IIIB) was found to be a statistically significant factor influencing @entity1349 (p = 0.026), and the histologic features, grade, @entity5 size as measured on CT scans, age, @entity286 use, weight loss >or=5%, and total dose delivered to the @entity5 were not. A KPS of <or=70 (p = 0.001), the presence of a CIRS-G score of 4 (extremely severe; p = 0.0002), and a severity index of >2 (p <0.0001) were associated with statistically significant inferior @entity1349 . Multivariate analysis with clinical stage, KPS, and comorbidity (severity index) of all @entity1 showed that a KPS <or=70 and severity index >2 were independently associated with inferior @entity1349 ; clinical @entity5 stage was not found to be an independent prognostic factor. CONCLUSION: KPS and comorbidity are important independent prognostic factors in @entity5 . Comorbidity should be included in protocols studying advanced stage @entity1149 and used for stratification.
