Prospective evaluation of quality of life effects in patients undergoing palliative radiotherapy for brain metastases

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• 作者：Diana Steinmann (1)
  Yvonne Paelecke-Habermann (2)
  Hans Geinitz (3)
  Raimund Aschoff (4)
  Anja Bayerl (5)
  Tobias B?lling (6)
  Elisabeth Bosch (7)
  Frank Bruns (1)
  Ute Eichenseder-Seiss (5)
  Johanna Gerstein (8)
  Nadine Gharbi (3)
  Juliane Hagg (9)
  Matthias Hipp (10)
  Irmgard Kleff (11)
  Axel Müller (3)
  Christof Sch?fer (10)
  Ursula Schleicher (7)
  Susanne Sehlen (12)
  Marilena Theodorou (3)
  Hans-Joachim Wypior (13)
  Franz Zehentmayr (14)
  Birgitt van Oorschot (15)
  Dirk Vordermark (16)
  
• 关键词：Brain tumours ; EORTC ; QLQ ; C15 ; PAL ; EORTC ; BN20 ; Whole ; brain radiotherapy
• 刊名：BMC Cancer
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：12
• 期：1
• 全文大小：213KB
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  39. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/12/283/prepub
  
• 作者单位：Diana Steinmann (1)
  Yvonne Paelecke-Habermann (2)
  Hans Geinitz (3)
  Raimund Aschoff (4)
  Anja Bayerl (5)
  Tobias B?lling (6)
  Elisabeth Bosch (7)
  Frank Bruns (1)
  Ute Eichenseder-Seiss (5)
  Johanna Gerstein (8)
  Nadine Gharbi (3)
  Juliane Hagg (9)
  Matthias Hipp (10)
  Irmgard Kleff (11)
  Axel Müller (3)
  Christof Sch?fer (10)
  Ursula Schleicher (7)
  Susanne Sehlen (12)
  Marilena Theodorou (3)
  Hans-Joachim Wypior (13)
  Franz Zehentmayr (14)
  Birgitt van Oorschot (15)
  Dirk Vordermark (16)
  
  1. Radiation Oncology, Medical School Hannover, Hannover, Germany
  2. Radiation Oncology, Martin Luther University, Halle/Saale, Germany
  3. Radiation Oncology, TU München, München, Germany
  4. Radiation Oncology, St.-Josef-Hospital Gelsenkirchen-Horst, Gelsenkirchen, Germany
  5. Radiation Oncology Radiation Oncology, Hospital Krems, Krems, Austria
  6. Radiation Oncology, University of Münster, Münster, Germany
  7. Radiation Oncology, Hospital Düren, Düren, Germany
  8. Radiation Oncology, University of Frankfurt/Main, Frankfurt/Main, Germany
  9. Radiation Oncology, University of Ulm, Ulm, Germany
  10. Radiation Oncology, University of Regensburg, Regensburg, Germany
  11. Radiation Oncology, Hospital Traunstein, Traunstein, Germany
  12. Radiation Oncology, LMU München, München, Germany
  13. Radiation Oncology, Hospital Landshut, Landshut, Germany
  14. Radiation Oncology, Hospital Salzburg, Salzburg, Austria
  15. Radiation Oncology, University of Würzburg, Würzburg, Germany
  16. Radiation Oncology, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany
  
• ISSN：1471-2407

文摘

Background Recently published results of quality of life (QoL) studies indicated different outcomes of palliative radiotherapy for brain metastases. This prospective multi-center QoL study of patients with brain metastases was designed to investigate which QoL domains improve or worsen after palliative radiotherapy and which might provide prognostic information. Methods From 01/2007-01/2009, n=151 patients with previously untreated brain metastases were recruited at 14 centers in Germany and Austria. Most patients (82 %) received whole-brain radiotherapy. QoL was measured with the EORTC-QLQ-C15-PAL and brain module BN20 before the start of radiotherapy and after 3 months. Results At 3 months, 88/142 (62 %) survived. Nine patients were not able to be followed up. 62 patients (70.5 % of 3-month survivors) completed the second set of questionnaires. Three months after the start of radiotherapy QoL deteriorated significantly in the areas of global QoL, physical function, fatigue, nausea, pain, appetite loss, hair loss, drowsiness, motor dysfunction, communication deficit and weakness of legs. Although the use of corticosteroid at 3 months could be reduced compared to pre-treatment (63 % vs. 37 %), the score for headaches remained stable. Initial QoL at the start of treatment was better in those alive than in those deceased at 3 months, significantly for physical function, motor dysfunction and the symptom scales fatigue, pain, appetite loss and weakness of legs. In a multivariate model, lower Karnofsky performance score, higher age and higher pain ratings before radiotherapy were prognostic of 3-month survival. Conclusions Moderate deterioration in several QoL domains was predominantly observed three months after start of palliative radiotherapy for brain metastases. Future studies will need to address the individual subjective benefit or burden from such treatment. Baseline QoL scores before palliative radiotherapy for brain metastases may contain prognostic information.