Effects of Radiotherapy for Brain Metastases on Quality of Life (QoL) Prospective Pilot Study of the DEGRO QoL Working Party

• Published in: Strahlentherapie und Onkologie Vol. 185; no. 3; pp. 190 - 197
• Main Authors: Steinmann, Diana, Schäfer, Christof, van Oorschot, Birgitt, Wypior, Hans-Joachim, Bruns, Frank, Bölling, Tobias, Sehlen, Susanne, Hagg, Juliane, Bayerl, Anja, Geinitz, Hans, Hipp, Matthias, Vordermark, Dirk
• Format: Journal Article
• Language: English
• Published: Munchen Urban and Vogel 01.03.2009; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Brain Neoplasms - epidemiology; Brain Neoplasms - radiotherapy; Brain Neoplasms - secondary; Female; Germany - epidemiology; Humans; Incidence; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Pilot Projects; Quality of Life; Radiotherapy; Radiotherapy, Conformal - statistics & numerical data; Risk Assessment - methods; Risk Factors; Survival Analysis; Survival Rate; Treatment Outcome; Germany; Hirnmetastasen; Lebensqualität; Brain metastases; Radiotherapy; Quality of life; Strahlentherapie
• ISSN: 0179-7158; 1439-099X
• DOI: 10.1007/s00066-009-1904-0

Background: Prospective data on quality-of-life (QoL) effects of radiotherapy for brain metastases are currently lacking, but would be of great interest to guide therapeutic decisions. Patients and Methods: From 01/2007 to 08/2007, 46 patients with previously untreated brain metastases were recruited at eight centers. QoL was measured at start of treatment (T 0 ) and at 3 months (T 3mo ). In the pilot study, two combinations of QoL instruments could be used at the discretion of the centers (A: EORTC QLQ-C30 and B: EORTC QLQ-C15-PAL both with brain module BN20, assessment by proxies with A: Palliative Care Outcome Scale, B: self-constructed brain-specific instrument). Results: All patients received whole-brain radiotherapy, four with an additional boost irradiation. At T 3mo , 26/46 patients (56.5%) had died. 17/20 survivors (85%) completed the questionnaires. In 3-month survivors, QoL deteriorated in most domains, significant in drowsiness, hair loss and weakness of legs. The scores for headaches and seizures were slightly better after 3 months. Assessment by proxies also suggested worsening of QoL. Initial QoL at T 0 was better in those alive than in those deceased at T 3mo , significant for physical function and for the symptom scales of fatigue and pain, motor dysfunction, communication deficit and weakness of legs. Conclusion: Practicability and compliance appeared better with the (shorter) version B. This version is now used in the ongoing main phase of the study with additional centers. First results indicate a moderate worsening of QoL during the first 3 months after start of palliative radiotherapy for brain metastases. QoL at initiation of radiotherapy may be prognostic for survival.