title: Somnolence syndrome in patients receiving radical radiotherapy for primary brain tumours: a prospective study.
abstract: OBJECTIVE
  To characterise the incidence, pattern and severity of post cranial radiotherapy somnolence and to identify factors predictive of frequency and severity.
  
  
  METHODS
  Seventy consecutive patients receiving radical cranial irradiation were prospectively assessed for somnolence at baseline, during and up to 10weeks following radiotherapy using five variables scored on a visual analogue scale (VAS) and the Littman scale. Fatigue was measured using the FACT-G score and quality of life using the EORTC QLQC30+3 with the brain tumour module questionnaire.
  
  
  RESULTS
  Ninety percent of patients experienced ⩾grade 1 somnolence (Littman score) and this correlated with VAS scores (r=0.456, p<0.001). The score increased from 3 to 12weeks (p<0.001) with a peak at the end of treatment and improvement 6weeks later. None of the patient, disease or treatment characteristics analysed were predictive for the development or the severity of somnolence.
  
  
  CONCLUSIONS
  The majority of patients experience some degree of somnolence following radical radiotherapy for primary brain tumour and this follows a clear pattern during and after treatment. While there are no clear predictors of severity, the pattern described allows for provision of information for patients and carers to minimise the distress the syndrome may cause.
authors.affiliation: Neuro-Oncology Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK.
authors.forename: Cerri
authors.initials: C
authors.lastname: Powell
authors.forename: Douglas
authors.initials: D
authors.lastname: Guerrero
authors.forename: Susan
authors.initials: S
authors.lastname: Sardell
authors.forename: Sebastian
authors.initials: S
authors.lastname: Cumins
authors.forename: Beverley
authors.initials: B
authors.lastname: Wharram
authors.forename: Daphne
authors.initials: D
authors.lastname: Traish
authors.forename: Adam
authors.initials: A
authors.lastname: Gonsalves
authors.forename: Sue
authors.initials: S
authors.lastname: Ashley
authors.forename: Michael
authors.initials: M
authors.lastname: Brada
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D016371:Cranial Irradiation / Q000009:adverse effects*; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology / Q000209:etiology*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life