Quality of life after palliative radiotherapy in bone metastases: A literature review

McDonald, Rachel; Chow, Edward; Rowbottom, Leigha; Bedard, Gillian; Lam, Henry; Wong, Erin; Popović, Marko; Pulenzas, Natalie; Tsao, May

doi:10.1016/j.jbo.2014.11.001

Cited by 51 publications

(37 citation statements)

References 26 publications

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“…Moreover, patients who received a BMdirected treatment such as bisphosphonates or PRRT tended to have a slightly better median OS, even though the difference was not significant ( p = 0.39). Another valid option for the treatment of pain caused by BM is palliative radiation, which has demonstrated a positive effect on the quality of life [24] . Neurological complications such as compression of the spinal cord were only seen in 4 out of 85 patients, which is significantly less than observed in the study by Van Loon et al [20] .…”

Section: Complications In Patients With Bm and Treatment Optionsmentioning

confidence: 99%

Bone Metastases in Patients with Neuroendocrine Neoplasm: Frequency and Clinical, Therapeutic, and Prognostic Relevance

Scharf¹,

Petry²,

Daniel³

et al. 2017

Neuroendocrinology

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Background: The incidence and prevalence of neuroendocrine neoplasms (NEN) are rising. In view of continuously improving imaging techniques, more than half of the patients present with distant metastases at initial diagnosis. An advanced disease stage negatively correlates with the 5-year survival rate. In stage IV disease, bone metastases (BM) are frequent, yet knowledge concerning their clinical or prognostic relevance is rare. This study presents a single-center experience on the frequency and management of BM in patients with gastroenteropancreatic NEN and lung carcinoids. Methods: Between 2000 and June 2015, 327 of 677 patients treated in the European Neuroendocrine Tumor Society (ENETS) center in Marburg (Germany) presented with distant metastases (48.3%), including 85 patients (12.6%) with BM. Data of both groups were analyzed using descriptive statistics. Overall survival was assessed by Kaplan-Meier curves and compared by log-rank test. Results: Median age in the BM group was 54.9 years, the small intestine and the pancreas being the most common primaries. 83.5% of the tumors were well and moderately differentiated (G1/G2). Nearly half of the patients with BM were symptomatic and suffered either from pain (42.4%) or had fractures (11.7%). Bisphosphonates were employed in almost two-thirds of the patients, radiation therapy in 25.9%. Overall survival was significantly inferior in patients with BM than in those with other distant metastases (p = 0.01; 49.0 vs. 100.8 months). Conclusion: BM appear to have a significant clinical and prognostic impact. Further studies are needed to evaluate therapeutic approaches directed to the treatment of BM in particular for asymptomatic patients.

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Section: Complications In Patients With Bm and Treatment Optionsmentioning

confidence: 99%

Bone Metastases in Patients with Neuroendocrine Neoplasm: Frequency and Clinical, Therapeutic, and Prognostic Relevance

Scharf¹,

Petry²,

Daniel³

et al. 2017

Neuroendocrinology

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“…To determine whether patients with an intermediate level of PD at baseline might have more chance of converting to a high level of PD during follow-up, the patients below the cutoff value were divided into two groups: low (7)(8)(9)(10)(11) and an intermediate (12)(13)(14)(15)(16) level.…”

Section: Psychological Distressmentioning

confidence: 99%

“…Painful bone metastases have a negative impact on the QoL of patients [5,6]. Studies show that radiotherapy stabilizes or improves QoL [7][8][9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

et al. 2017

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Background: Psychological distress (PD) has a major impact on quality of life. We studied the incidence of PD before and after radiotherapy for painful bone metastases. Furthermore, we aimed to identify factors predictive for PD. Methods: Between 1996 and 1998, the Dutch Bone Metastasis Study included 1157 patients with painful bone metastases. Patients were randomized between two fractionation schedules. The study showed a pain response of 74% in both groups. Patients filled out weekly questionnaires for 13 weeks, then monthly for two years. The questionnaires included a subscale for PD on the Rotterdam Symptom Checklist. We used generalized estimating equations and multivariable logistic regression analyses. Results: At baseline, 290 patients (27%) had a high level of PD. For the entire group, the level of PD remained constant over time. The majority of patients with a low level of PD at baseline remained at a low level during follow-up. In patients with a high level of PD at baseline, the mean level of PD decreased after treatment and stabilized around the cutoff level. Female patients, higher age, worse performance, lower pain score and worse self-reported QoL were associated with an increased chance of PD, although the model showed moderate discriminative power. Conclusions: A substantial proportion of patients had a high level of PD before and after radiotherapy for painful bone metastases. Most patients who reported high levels of PD when referred for palliative radiotherapy remained at high levels thereafter. Therefore, screening of PD prior to treatment seems appropriate, in order to select patients requiring intervention.

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“…This study also showed significant improvements in similar items. According to the literature, several studies (in- with pain relief [13]. These studies suggest the association between symptom relief and an improvement in the QOL after palliative radiotherapy in patients with bone metastasis.…”

Section: Discussionmentioning

confidence: 97%

Evaluation of Quality of Life and Psychological Response in Recurrent and Metastatic Tumors Treated with Palliative Radiotherapy

Yamano¹,

Takahashi²,

Ueno³

et al. 2018

JCT

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Objective: We evaluated the effects of palliative radiotherapy for cancer recurrence or metastasis on patient QOL and psychophysiology. Materials and Methods: Sixty seven patients who received palliative radiotherapy between 2014 and 2015 were enrolled. Patient diseases were bone metastasis in 51 patients, lymph node metastasis in 7 patients, brain metastasis in 2 patients, local recurrence in 3 patients, and others in 4 patients. Median irradiated dose was 30 Gy in 10 fractions for palliative radiotherapy. We used the questionnaires EORTC-QLQ-C30 and EORTC-QLQ-C15-PAL to evaluate patient QOL and the Hospital Anxiety and Depression Scale to evaluate patient mental healthcare at the start and at the end of radiotherapy. Results: As compared to scores at the start of radiotherapy, at the end of radiotherapy, NRS and face scale significantly decreased. On the other hand, Eastern Cooperative Oncology Group Performance Status did not show any changes during palliative radiotherapy. In functional scales, average scores of RF2 and EF also improved. In symptom scales, average scores of FA, PA, and SL improved. In bone metastasis group, global health status/QOL, PA, and SL significantly improved. There was relationship between anxiety improvement and QOL improvement after palliative radiotherapy. Nausea and vomiting scores of EORTC-QLQ-C15-PAL were associated with the irradiated volume of palliative radiotherapy for pelvic region. Conclusion: Patient QOL of was improved by palliative radiotherapy regardless of PS. The possibility of palliative radiotherapy having a positive influence on patient psychophysiology was also suggested in younger age.

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Quality of life after palliative radiotherapy in bone metastases: A literature review

Cited by 51 publications

References 26 publications

Bone Metastases in Patients with Neuroendocrine Neoplasm: Frequency and Clinical, Therapeutic, and Prognostic Relevance

Bone Metastases in Patients with Neuroendocrine Neoplasm: Frequency and Clinical, Therapeutic, and Prognostic Relevance

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

Evaluation of Quality of Life and Psychological Response in Recurrent and Metastatic Tumors Treated with Palliative Radiotherapy

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