Symptoms and quality of life in cancer patients with brain metastases following palliative radiotherapy.
OBJECTIVE
To examine prospectively patient self-rated symptoms and quality of life (QOL) indicators in patients with brain metastases following whole brain radiotherapy (WBRT).


METHODS
Consecutive patients with brain metastases referred for WBRT were approached for this study. Patients were asked to rate their symptoms and QOL using the Spitzer Quality of Life Index questionnaire. Follow-up was at 1, 2, and 3 months following WBRT. Linear regression analysis was used to determine the change in symptom severity over time.


RESULTS
Between August 2005 to October 2007, 129 patients with brain metastases were enrolled. The majority of patients (88%) received 20 Gy in five fractions. Median age was 64 years, and median Karnofsky Performance Status at baseline was 70. The most commonly experienced symptoms at baseline were headaches, weakness, balance problems, and fatigue. Thirty-five percent of patients rated neurological functional (NF) status as 1, indicating moderate neurological symptoms and need for assistance. Forty-three percent of patients had stable or decreased fatigue, and 47% had a stable or improved NF status over time (p = 0.0040). Although certain QOL domains improved over time, all other QOL domains and symptom items did not change significantly following WBRT.


CONCLUSIONS
WBRT may have contributed to symptom stabilization in our study. An alternative goal of WBRT may be the prevention of symptom progression and QOL deterioration. Further research is required to select the most appropriate group of patients with brain metastases who would benefit most from WBRT.
Wong
Jennifer
J
Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada.
Hird
Amanda
A
Zhang
Liying
L
Tsao
May
M
Sinclair
Emily
E
Barnes
Elizabeth
E
Danjoux
Cyril
C
Chow
Edward
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology; D003221:Confusion; D016371:Cranial Irradiation; D004244:Dizziness / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D017567:Karnofsky Performance Status; D016014:Linear Models; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life