title: [Supportive care, cognition and quality of life in brain metastases].
abstract: Brain metastases impact on the survival of the patients, but on their quality of life as well. The objective of the management of these patients is then double. Currently, due to medical advances, survivals tend to improve, especially for some tumor subtypes. During the course of the disease, different neurological signs and symptoms can be observed according to the location, the number and the volume of the metastase(s). Patients and caregivers are especially worried about the loss of autonomy and cognitive impairments. A permanent dialogue, during the course of the disease, is mandatory, in order to adapt the management to the objectives determined by the patients and the medical team. These objectives may vary according to the objective response rates of the disease to anticancer therapies, according to the impact of the disease and its management in daily living. Anticancer therapies and supportive care must be appreciated according to their impact on the survival, on the preservation of the functional independence and the quality of life of the patient, on their abilities to preserve the neurological status and delay the apparition of new neurological signs and symptoms, and their adverse events. Supportive care, cognition and quality of life should be regularly evaluated and adapted according to the objectives of the management of brain metastases patients. Different approaches are described in this paper.
authors: Neuro-oncologie, département de neurochirurgie, hôpital Roger-Salengro, CHRU, rue Émile-Laine, 59037 Lille cedex, France; Oncologie médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France; Inserm U1192, laboratoire Prism, université Lille 1, bâtiment SN3 1(er) étage, 59655 Villeneuve d'Ascq cedex, France; Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC), 13273 Marseille cedex 09, France. Electronic address: emilie.lerhun@chru-lille.fr.
authors: É
authors: É
authors: Le Rhun
authors: Neuro-oncologie, neurologie 2, groupe hospitalier Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Radiothérapie et neuro-oncologie, groupe hospitalier Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors: S
authors: S
authors: Taillibert
authors: Neuro-oncologie, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, CO 60034, 54035 Nancy, France.
authors: M
authors: M
authors: Blonski
authors: Neuro-oncologie, neurologie 2, groupe hospitalier Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors: N
authors: N
authors: Jouniaux Delbez
authors: Neuro-oncologie, neurologie 2, groupe hospitalier Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors: D
authors: D
authors: Delgadillo
authors: Neurologie, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris cedex 05, France.
authors: H
authors: H
authors: Taillia
authors: Unité de recherche en santé publique, maladies chroniques et qualité de vie, faculté de médecine Timone, 27, boulevard Jean-Moulin, 13005 Marseille, France.
authors: P
authors: P
authors: Auquier
authors: Service de neurologie, CHU Avicenne AP-HP, 125, rue de Stalingrad, 93009 Bobigny cedex, France.
authors: C
authors: C
authors: Belin
authors: Méthodologie et qualité de vie en oncologie, EA 3181, CHU de Besançon, 2, boulevard Fleming, 25030 Besançon, France; Plateforme qualité de vie et recherche clinique en oncologie, CHU de Besançon, 2, boulevard Fleming, 25030 Besançon, France.
authors: F
authors: F
authors: Bonnetain
authors: Soins palliatifs, groupe hospitalier Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors: D
authors: D
authors: Varin
authors: Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC), 13273 Marseille cedex 09, France; Département d'oncologie-radiothérapie, institut Paoli-Calmettes, 232, boulevard Sainte-Marguerite, 13009 Marseille, France.
authors: A
authors: A
authors: Tallet
authors: Inserm U1192, laboratoire Prism, université Lille 1, bâtiment SN3 1(er) étage, 59655 Villeneuve d'Ascq cedex, France.
authors: L
authors: L
authors: Taillandier
mesh_terms: D000203:Activities of Daily Living; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D001334:Automobile Driving; D001932:Brain Neoplasms / Q000150:complications / Q000523:psychology / Q000556:secondary* / Q000628:therapy; D017028:Caregivers / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D003131:Combined Modality Therapy; D004827:Epilepsy / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D006801:Humans; D019586:Intracranial Hypertension / Q000188:drug therapy / Q000209:etiology; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010353:Patient Education as Topic; D010361:Patients / Q000523:psychology; D026684:Personal Autonomy; D011788:Quality of Life; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control
chemical_list: D000305:Adrenal Cortex Hormones; D000925:Anticoagulants; D000927:Anticonvulsants
keywords: Brain metastases; Cognition; Corticotherapy; Corticothérapie; Epilepsy; Maladie thromboembolique; Métastases cérébrales; Quality of life; Qualité de vie; Thromboembolic disease; Épilepsie