Symptom response after palliative radiotherapy for patients with brain metastases.
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.
Bezjak
A
A
Palliative Radiation Oncology Program, Department of Radiation Oncology, Princess Margaret Hospital, University Health Network, University of Toronto, M5G 2M9, Toronto, Canada.
Adam
J
J
Barton
R
R
Panzarella
T
T
Laperriere
N
N
Wong
C S
CS
Mason
W
W
Buckley
C
C
Levin
W
W
McLean
M
M
Wu
J S Y
JS
Sia
M
M
Kirkbride
P
P
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