Investigating the Palliative Efficacy of Whole-brain Radiotherapy for Patients with Multiple-brain Metastases and Poor Prognostic Features

Gerrard, G.; Prestwich, R.; Edwards, A. J.; Russon, Lynne; Richards, Frederick; Johnston, C.F.; Kwok‐Williams, Michelle

doi:10.1016/s0936-6555(03)00148-1

Cited by 53 publications

(52 citation statements)

References 15 publications

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“…Another study investigated the survival and QOL of patients who were randomized to WBRT with efaproxiral or to WBRT alone 70 . Six other studies examined the role of QOL or patient-rated symptoms when assessing the effectiveness of WBRT 17,[71][72][73][74][75] . Two studies assessed the neurocognitive function (NCF) of patients who had been treated with WBRT and a radiosensitizer 76 or with WBRT alone 27 .…”

Section: Multiple Brain Metastasesmentioning

confidence: 99%

“…Gerrard et al 72 , Yaneva et al 75 , and Roos et al 39 used the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30). This general questionnaire consists of 5 domains assessing functioning (physical, role, cognitive, emotional, and social), 1 domain assessing global QOL, 3 domains assessing common symptoms (fatigue, pain, nausea or vomiting), 5 single items assessing other symptoms (dyspnea, insomnia, anorexia, constipation, and diarrhea), and 1 item assessing financial impact.…”

mentioning

confidence: 99%

“…Gerrard et al 72 and Roos et al 39 used the supplementary Brain Cancer Module (BCM) in addition to the EORTC QLQ-C30. However, the BCM was designed for patients with primary brain tumour.…”

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confidence: 99%

“…When using the EORTC QLQ-C30 and BCM, Gerrard et al 72 experienced difficulties with data collection and found that the questionnaires were lengthy and demanding, particularly for their poor-prognosis group. From the 18 patients analyzed in their first study, high levels of fatigue and drowsiness were seen throughout the study period (baseline to 8 weeks) and only 1 patient and 2 patients improved in QOL at 2 weeks and 4 weeks respectively.…”

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confidence: 99%

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Quality of Life in Brain Metastases Radiation Trials: A Literature Review

et al. 2008

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BackgroundAn estimated 20%-40% of cancer patients will develop brain metastases. Whole-brain radiotherapy (WBRT) is the standard treatment for patients with brain metastases. Although WBRT can reduce neurologic symptoms, the median survival following WBRT is between 3 and 6 months. Given this limited survival, it is important to consider quality of life (QOL) when treating patients with brain metastases. However, few studies have focused on QOL and improvement in patient-rated symptoms as primary outcomes. ObjectiveFor an accurate measurement of the extent to which previous trials have utilized QOL tools to evaluate the efficacy of WBRT for treatment of brain metastases, we undertook a literature review to examine the common endpoints and QOL instruments used. MethodsWe conducted a systematic search using the MEDLINE (1950( to December 2007 and Cochrane Central Register of Controlled Trials (4th quarter 2007) databases. Eligible studies investigated WBRT in one of the study arms. The following outcomes were included: median survival, overall survival, neurologic function, 1-year local control, and overall response; use of QOL instruments, performance status scales, and neurologic function assessments; and use of other assessment tools. Patient-rated QOL instruments were defined as those that strove to assess all dimensions of QOL; observerrated performance instruments such as the Karnofsky performance status (KPS) were deemed to be performance scales. ResultsWe identified sixty-one trials that included WBRT nine evaluated the treatment of a single brain metastasis, and fifty-two evaluated the treatment of multiple brain metastases. Although fifty-five of the trials employed a QOL instrument, few trials focused on QOL as an outcome. We found 23 different instruments used to evaluate QOL. The most commonly employed instrument was the KPS (n = 33), followed by various neurologic function classification scales (n = 21). A preponderance of the studies used 1 (n = 26, 43%) or 2 (n = 21, 34%) QOL instruments.A total of fourteen published trials on brain metastases included an evaluation of the study population's QOL. Those trials included three that used the Functional Assessment of Cancer Therapy-General scale and Brain subscale instrument, three that used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (C30) and the Brain Cancer Module 20 instrument, two that used study-designed QOL instruments, one that used the Edmonton Symptom Assessment Scale, two that used the Spitzer Quality of Life index, and three that used the KPS to evaluate QOL. Some trials reported deterioration in QOL after WBRT in patients with poorer prognosis; other trials detected an improvement in QOL after WBRT in patients with better prognosis. ConclusionsTo date, fourteen trials in brain metastases that have included an evaluation of the study population's QOL have been published. Although some studies showed that certain parameters of QOL deteriorate after WBRT, other studies showed that Q...

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Section: Multiple Brain Metastasesmentioning

confidence: 99%

mentioning

confidence: 99%

“…Gerrard et al 72 and Roos et al 39 used the supplementary Brain Cancer Module (BCM) in addition to the EORTC QLQ-C30. However, the BCM was designed for patients with primary brain tumour.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Quality of Life in Brain Metastases Radiation Trials: A Literature Review

et al. 2008

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“…Studies of patients with brain metastases continue to use the lengthy QLQ-C30 along with the QLQ-BN20 as there is no tool that has been validated specifically for use in this patient population [14][15][16][17]. A previous study assessed QOL in patients with brain metastases prior to and after treatment by administering the QLQ-C15-PAL with the QLQ-BN20+2, a version of the QLQ-BN20 questionnaire with two additional questions to assess cognitive function [18].…”

Section: Introductionmentioning

confidence: 99%

Content validation of the EORTC QLQ-BN20+2 with patients and health care professionals to assess quality of life in brain metastases

et al. 2012

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Objective The validated EORTC quality of life (QOL) questionnaire QLQ-BN20 is a cancer subtype-specific supplement to the QLQ-C30 general QOL questionnaire for patients with primary brain neoplasms. The QLQ-C15-PAL core palliative questionnaire is an abbreviated version of the QLQ-C30 designed to decrease patient burden. We conducted content validation of the QLQ-BN20+2 for patients with brain metastases. Methods and materials Patients undergoing treatment for brain metastases, along with health care professionals (HCPs) completed the QLQ-C15-PAL and QLQ-BN20+2 questionnaires. A structured interview followed to assess for any difficulties with the QLQ-BN20+2, irrelevant items, and whether additional pertinent items should be included. Results Seventy-four patients and 71 HCPs participated. The majority of patients (84 %) were treated with whole-brain radiotherapy only. Over 50 % of patients felt that seizures, hair loss and trouble controlling bladder were not related to brain metastases. Questions regarding uncertainty about the future were the most difficult, although still a small proportion (12-16 %). All items were endorsed by over 50 % of HCPs as 'quite' or 'very' relevant to brain metastases patients, with two exceptions: 15 and 12 % of HCPs rated pruritis and future uncertainty as irrelevant, respectively. Conclusion We report the first content validation of the QLQ-BN20+2 and QLQ-C15-PAL QOL questionnaires for patients undergoing treatment for brain metastases, demonstrating feasibility and relevance. These questionnaires should be used together as universal QOL assessment tools in this setting.

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Managing Complications of Cancer

Barton¹

2005

Handbook of Palliative Care

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Investigating the Palliative Efficacy of Whole-brain Radiotherapy for Patients with Multiple-brain Metastases and Poor Prognostic Features

Cited by 53 publications

References 15 publications

Quality of Life in Brain Metastases Radiation Trials: A Literature Review

Quality of Life in Brain Metastases Radiation Trials: A Literature Review

Content validation of the EORTC QLQ-BN20+2 with patients and health care professionals to assess quality of life in brain metastases

Managing Complications of Cancer

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