@article{c39e6d2e018a4908b1575aa5182667d5,
title = "Neighborhood Deprivation and Rurality Associated With Patient-Reported Outcomes and Survival in Men With Prostate Cancer in NRG Oncology RTOG 0415",
abstract = "Purpose: Rurality and neighborhood deprivation can contribute to poor patient-reported outcomes, which have not been systematically evaluated in patients with specific cancers in national trials. Our objective was to examine the effect of rurality and neighborhood socioeconomic and environmental deprivation on patient-reported outcomes and survival in men with prostate cancer in NRG Oncology RTOG 0415. Methods and Materials: Data from men with prostate cancer in trial NRG Oncology RTOG 0415 were analyzed; 1,092 men were randomized to receive conventional radiation therapy or hypofractionated radiation therapy. Rurality was categorized as urban or rural. Neighborhood deprivation was assessed using the area deprivation index and air pollution indicators (nitrogen dioxide and particulate matter with a diameter less than 2.5 micrometers) via patient ZIP codes. Expanded Prostate Cancer Index Composite measured cancer-specific quality of life. The Hopkins symptom checklist measured anxiety and depression. EuroQoL–5 Dimension assessed general health. Results: We analyzed 751 patients in trial NRG Oncology RTOG 0415. At baseline, patients from the most deprived neighborhoods had worse bowel (P = .011), worse sexual (P = .042), and worse hormonal (P = .015) scores; patients from the most deprived areas had worse self-care (P = .04) and more pain (P = .047); and patients from rural areas had worse urinary (P = .03) and sexual (P = .003) scores versus patients from urban areas. Longitudinal analyses showed that the 25% most deprived areas (P = .004) and rural areas (P = .002) were associated with worse EuroQoL–5 Dimension visual analog scale score. Patients from urban areas (hazard ratio, 1.81; P = .033) and the 75% less-deprived neighborhoods (hazard ratio, 0.68; P = .053) showed relative decrease in risk of recurrence or death (disease-free survival). Conclusions: Patients with prostate cancer from the most deprived neighborhoods and rural areas had low quality of life at baseline, poor general health longitudinally, and worse disease-free survival. Interventions should screen populations from deprived neighborhoods and rural areas to improve patient access to supportive care services.",
author = "Jinbing Bai and Pugh, {Stephanie L.} and Ronald Eldridge and Yeager, {Katherine A.} and Qi Zhang and Lee, {W. Robert} and Shah, {Amit B.} and Dayes, {Ian S.} and D'Souza, {David P.} and Michalski, {Jeff M.} and Efstathiou, {Jason A.} and Longo, {John M.} and Pisansky, {Thomas M.} and Maier, {Jordan M.} and Faria, {Sergio L.} and Desai, {Anand B.} and Seaward, {Samantha A.} and Sandler, {Howard M.} and Cooley, {Mary E.} and Bruner, {Deborah W.}",
note = "Funding Information: This project was supported by grants U10CA180868 (NRG Oncology Operations), U10CA180822 (NRG Oncology SDMC), and UG1CA189867 (NCORP) from the National Cancer Institute . J.B. was supported by grants from the National Institutes of Health / National Institute of Nursing Research ( 4R00NR017897-03 ) and by the NRG Oncology NCORP and Cancer Care Delivery Research (CCDR) Pilot Award. Funding Information: Disclosures: D.W.B. declares in the past 36 months consulting fees from Flatiron Health Inc. M.E.C. declares in the past 36 months participation on a data safety and monitoring board for a PediQuest grant and funds paid to Dana-Farber Cancer Institution. J.A.E. declares in the past 36 months consulting fees from Blue Earth Diagnostics, AstraZeneca, Boston Scientific, and Taris Biomedical; participation on a data safety and monitoring board or advisory board for Merck, Roivant Pharma, Myovant Sciences, Bayer Healthcare, and Progenics; and leadership or fiduciary role in another board, society, committee, or advocacy group, paid or unpaid with American College of Radiation Oncology, Radiation Oncology Institute, Massachusetts Prostate Cancer Coalition, and NRG Oncology. H.M.S. declares in the past 36 months membership of a clinical trial steering committee for Janssen and the American Society for Radiation Oncology board of directors, and low-value stock from an inactive advisory board role for Radiogel. K.A.Y. declares in the past 36 months participation as chair of a health disparities committee for NRG Oncology (received subaward from NRG Oncology Network Group Operations Center/NRG Oncology Foundation funded by NIH/National Cancer Institute [grant #U10CA180868-05] until 2/28/21). All other authors have nothing to declare. Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",
year = "2023",
month = may,
day = "1",
doi = "10.1016/j.ijrobp.2023.01.035",
language = "English",
volume = "116",
pages = "39--49",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
number = "1",
}