title: Quality of life after stereotactic body radiation therapy for primary and metastatic liver tumors.
abstract: OBJECTIVE
  Stereotactic body radiation therapy (SBRT) provides a high local control rate for primary and metastatic liver tumors. The aim of this study is to assess the impact of this treatment on the patient's quality of life. This is the first report of quality of life associated with liver SBRT.
  
  
  METHODS
  From October 2002 to March 2007, a total of 28 patients not suitable for other local treatments and with Karnofsky performance status of at least 80% were entered in a Phase I-II study of SBRT for liver tumors. Quality of life was a secondary end point. Two generic quality of life instruments were investigated, EuroQol-5D (EQ-5D) and EuroQoL-Visual Analogue Scale (EQ-5D VAS), in addition to a disease-specific questionnaire, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ C-30). Points of measurement were directly before and 1, 3, and 6 months after treatment. Mean scores and SDs were calculated. Statistical analysis was performed using paired-samples t-test and Student t-test.
  
  
  RESULTS
  The calculated EQ-5D index, EQ-5D VAS and QLQ C-30 global health status showed that mean quality of life of the patient group was not significantly influenced by treatment with SBRT; if anything, a tendency toward improvement was found.
  
  
  CONCLUSIONS
  Stereotactic body radiation therapy combines a high local control rate, by delivering a high dose per fraction, with no significant change in quality of life. Multicenter studies including larger numbers of patients are recommended and under development.
authors.affiliation: Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. a.mendezromero@erasmusmc.nl
authors.forename: Alejandra
authors.initials: A
authors.lastname: Méndez Romero
authors.forename: Wouter
authors.initials: W
authors.lastname: Wunderink
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Os
authors.forename: Peter J C M
authors.initials: PJ
authors.lastname: Nowak
authors.forename: Ben J M
authors.initials: BJ
authors.lastname: Heijmen
authors.forename: Joost J
authors.initials: JJ
authors.lastname: Nuyttens
authors.forename: Rene P
authors.initials: RP
authors.lastname: Brandwijk
authors.forename: Cornelis
authors.initials: C
authors.lastname: Verhoef
authors.forename: Jan N M
authors.initials: JN
authors.lastname: Ijzermans
authors.forename: Peter C
authors.initials: PC
authors.lastname: Levendag
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017567:Karnofsky Performance Status; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D013238:Stereotaxic Techniques; D011795:Surveys and Questionnaires / Q000592:standards