title: Quality of life after palliative radiation therapy for patients with painful bone metastases: results of an international study validating the EORTC QLQ-BM22.
abstract: OBJECTIVE
  Radiation therapy (RT) is an effective method of palliating painful bone metastases and can improve function and reduce analgesic requirements. In advanced cancer patients, quality of life (QOL) is the primary outcome of interest over traditional endpoints such as survival. The purpose of our study was to compare bone metastasis-specific QOL scores among patients who responded differently to palliative RT.
  
  
  METHODS
  Patients receiving RT for bone metastases across 6 countries were prospectively enrolled from March 2010-January 2011 in a trial validating the QLQ-BM22 and completed the QLQ-BM22 and the core measure (QLQ-C30) at baseline and after 1 month. Pain scores and analgesic intake were recorded, and response to RT was determined according to the latest published guidelines. The Kruskal-Wallis nonparametric and Wilcoxon rank sum tests compared changes in QOL among response groups. A Bonferroni-adjusted P<.003 indicated statistical significance.
  
  
  RESULTS
  Of 79 patients who received palliative RT, 59 were assessable. Partial response, pain progression, and indeterminate response were observed in 22, 8, and 29 patients, respectively; there were no patients with a complete response. Patients across all groups had similar baseline QOL scores apart from physical functioning (patients who progressed had better initial functioning). One month after RT, patients who responded had significant improvements in 3 of 4 QLQ-BM22 domains (painful site, P<.0001; painful characteristic, P<.0001; and functional interference, P<.0001) and 3 QLQ-C30 domains (physical functioning, P=.0006; role functioning, P=.0026; and pain, P<.0001). Patients with progression in pain had significantly worse functional interference (P=.0007) and pain (P=.0019).
  
  
  CONCLUSIONS
  Patients who report pain relief after palliative RT also have better QOL with respect to bone metastasis-specific issues. The QLQ-BM22 and QLQ-C30 are able to discriminate among patients with varying responses and are recommended for use in future bone metastasis clinical trials.
authors: Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Liang
authors: L
authors: Zeng
authors: Edward
authors: E
authors: Chow
authors: Gillian
authors: G
authors: Bedard
authors: Liying
authors: L
authors: Zhang
authors: Alysa
authors: A
authors: Fairchild
authors: Vassilios
authors: V
authors: Vassiliou
authors: Mohamed A
authors: MA
authors: Alm El-Din
authors: Reynaldo
authors: R
authors: Jesus-Garcia
authors: Aswin
authors: A
authors: Kumar
authors: Fabien
authors: F
authors: Forges
authors: Ling-Ming
authors: LM
authors: Tseng
authors: Ming-Feng
authors: MF
authors: Hou
authors: Wei-Chu
authors: WC
authors: Chie
authors: Andrew
authors: A
authors: Bottomley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000532:radiotherapy*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D011795:Surveys and Questionnaires