title: Effects of radiotherapy for brain metastases on quality of life (QoL). Prospective pilot study of the DEGRO QoL working party.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Radiation Oncology, Medical School, Hannover, Germany. steinmann.diana@mh-hannover.de
authors.forename: Diana
authors.initials: D
authors.lastname: Steinmann
authors.forename: Christof
authors.initials: C
authors.lastname: Schäfer
authors.forename: Birgitt
authors.initials: B
authors.lastname: van Oorschot
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Wypior
authors.forename: Frank
authors.initials: F
authors.lastname: Bruns
authors.forename: Tobias
authors.initials: T
authors.lastname: Bölling
authors.forename: Susanne
authors.initials: S
authors.lastname: Sehlen
authors.forename: Juliane
authors.initials: J
authors.lastname: Hagg
authors.forename: Anja
authors.initials: A
authors.lastname: Bayerl
authors.forename: Hans
authors.initials: H
authors.lastname: Geinitz
authors.forename: Matthias
authors.initials: M
authors.lastname: Hipp
authors.forename: Dirk
authors.initials: D
authors.lastname: Vordermark