title: Symptom response after palliative radiotherapy for patients with brain metastases.
abstract: Whole brain radiotherapy (RT) is frequently used to palliate symptoms in patients with brain metastases, but the palliative benefit to patients has not been well documented. We conducted a longitudinal observational prospective study of patients receiving standard RT (20 Gray (Gy)/5 fractions) for symptomatic brain metastases. End-points were observer rating of neurological symptoms, patient-rated symptoms, performance status, neurological functional status, cognitive function and quality of life (QOL). Median survival for the 75 patients was 86 days (95% confidence interval (CI): 65-101 days). At 1 month, 19% of patients showed an improvement or resolution of presenting symptoms, 23% were stable and 55% had progressed or died. Patient-rated symptoms were increased at 1 month in comparison to baseline data. Only 4 patients had an improved performance status and 22 were stable. Many patients with brain metastases have a short life expectancy and may not benefit from even short duration radiation schedules. Further effort is needed to optimise patient selection and tailor treatment appropriately.
authors.affiliation: Palliative Radiation Oncology Program, Department of Radiation Oncology, Princess Margaret Hospital, University Health Network, University of Toronto, M5G 2M9, Toronto, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Bezjak
authors.forename: J
authors.initials: J
authors.lastname: Adam
authors.forename: R
authors.initials: R
authors.lastname: Barton
authors.forename: T
authors.initials: T
authors.lastname: Panzarella
authors.forename: N
authors.initials: N
authors.lastname: Laperriere
authors.forename: C S
authors.initials: CS
authors.lastname: Wong
authors.forename: W
authors.initials: W
authors.lastname: Mason
authors.forename: C
authors.initials: C
authors.lastname: Buckley
authors.forename: W
authors.initials: W
authors.lastname: Levin
authors.forename: M
authors.initials: M
authors.lastname: McLean
authors.forename: J S Y
authors.initials: JS
authors.lastname: Wu
authors.forename: M
authors.initials: M
authors.lastname: Sia
authors.forename: P
authors.initials: P
authors.lastname: Kirkbride
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D003072:Cognition Disorders / Q000209:etiology; D016371:Cranial Irradiation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D016019:Survival Analysis; D016896:Treatment Outcome