title: The EORTC QLQ-BN20 for assessment of quality of life in patients receiving treatment or prophylaxis for brain metastases: a literature review.
abstract: BACKGROUND
  Brain metastases occur in approximately 20-40% of cancer patients during the course of disease. As treatment for brain metastases is palliative over curative, quality of life (QoL) is emphasized over prolonged survival. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-BN20 is a QoL assessment specific to brain neoplasms. We aim to provide a review of the current use of the EORTC QLQ-BN20 for patients with brain metastases.
  
  
  METHODS
  All studies utilizing the QLQ-BN20 for QoL assessment in patients receiving treatments related to brain metastases were included. Study information including treatment type, assessment periods, patient enrolment and all information pertaining to the QLQ-BN20 were extracted.
  
  
  RESULTS
  A total of 13 studies were identified, five of which were randomized trials assessing prophylactic whole brain radiation for patients with small-cell lung cancer. The QLQ-BN20 was used in conjunction with the core QLQ-C30 questionnaire in all but one of the studies and together these comprised the entire QoL assessments for 11 of the 13 studies. Neurocognitive function assessments supplemented QoL in four studies and accompanying performance status indices used with the QLQ-BN20 varied. Compliance issues were commonly cited. QoL changes during study periods varied as improvements, deteriorations and stabilizations were all observed.
  
  
  CONCLUSIONS
  QoL assessments should be conducted using disease-specific tools. Future studies should minimize patient burden in order to maximize data collection and accrual. A common set of QoL end points for patients with brain metastases should be created.
authors.affiliation: Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Leung
authors.forename: Karen
authors.initials: K
authors.lastname: Lien
authors.forename: Liang
authors.initials: L
authors.lastname: Zeng
authors.forename: Janet
authors.initials: J
authors.lastname: Nguyen
authors.forename: Amanda
authors.initials: A
authors.lastname: Caissie
authors.forename: Shaelyn
authors.initials: S
authors.lastname: Culleton
authors.forename: Lori
authors.initials: L
authors.lastname: Holden
authors.forename: Edward
authors.initials: E
authors.lastname: Chow
mesh_terms: D001932:Brain Neoplasms / Q000517:prevention & control* / Q000523:psychology / Q000556:secondary / Q000628:therapy*; D006801:Humans; D009483:Neuropsychological Tests; D010166:Palliative Care; D011237:Predictive Value of Tests; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome