Main Session
Sep
28
PQA 04 - Breast Cancer, Patient Reported Outcomes/QoL/Survivorship, Functional Radiation Medicine, Hematologic Malignancies, Palliative Care, and International/Global Oncology
2823 - Long-Term Skin-Related Quality of Life in Patients Receiving Post-Operative Radiation Therapy for Cutaneous Melanoma
Presenter(s)
Kelsey Nordlund, BS - MD Anderson Cancer Center, Houston, TX
K. N. Nordlund1, A. F. M. Salem1, M. D. Soileau2, Y. Yi3, R. Lin4, B. A. Guadagnolo1, A. J. Bishop1, A. Farooqi1, A. K. Yoder1, and D. Mitra5; 1Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 2University of Houston, Houston, TX, 3The University of Texas MD Anderson Cancer Center, Houston, TX, 4Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 5Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Purpose/Objective(s): As patients with locoregionally advanced melanoma are surviving longer than ever, there is a critical need to understand the long-term side effects of locoregional radiotherapy (RT) to appropriately assess the relative risks versus benefits of treatment. Thus, we sought to assess the long-term quality of life (QoL) of patients who received 5-fraction post-operative locoregional RT at our institution. Materials/Methods: We identified 384 patients who received 30 Gy in 5 fractions (prescribed to Dmax, delivered twice weekly or every other business day) adjuvant primary site or nodal RT for cutaneous melanoma between 2009-2023 and were documented living at last follow-up. To assess skin-related quality of life, the Skindex-16 (SD16) patient-reported outcome survey was distributed (initially by email and for patients who did not opt out, subsequently by research staff telephone call). These post-RT SD16 scores (higher indicating worse QoL) were compared to baseline pre-RT SD16 scores from a parallel cohort of patients on a prospective skin toxicity monitoring study. Kruskal-Wallis Tests were used to test differences between cohorts. Results: 154 patients completed the SD16 survey (40% completion rate) at a median of 9 years (IQR 6-12) after RT. The median age was 62 (IQR 52-68) with 75% of respondents (n=115) being male. 89% underwent primary cutaneous tumor excision and 87% underwent nodal dissection. 68% (n=105) received primary site RT and 42% (n=64) received nodal site RT. Of these patients, 10% (n=15) received both primary and nodal RT. 27% received adjuvant systemic therapy with most receiving immunotherapy. Overall, the median post-RT SD16 score was 7 (IQR 0-20). Most patients received RT to the head and neck (HN; 68%, n=105) with median post-RT SD16 for this cohort also being 7 (IQR 1-21). The median pre-RT/post-op SD16 score for the control cohort was 0 (IQR 0-8, p=0.023). This difference was driven by the “symptom” subscale score (vs. “emotion” and “function” subscales) with a median post-RT SD16 symptom score of 8 (IQR 0-23) vs. pre-RT SD16 score of 0 (IQR 0-0, p<0.001). In contrast, there were no significant differences in pre- vs. post-RT SD16 scores for patients receiving non-HN RT. Conclusion: At a median 9 years after adjuvant melanoma RT there is minimal detriment in skin-related quality of life for HN patients and no significant difference for non-HN patients. Thus, adjuvant RT for cutaneous melanoma is well-tolerated with minimal impact on long term skin-related QoL.