OBJECTIVE: Brain radiotherapy is the main treatment for patients with brain metastases but its goal is just symptom control. Our aim was to study if different performance tools, used in geriatric practice, could improve patient selection for decision-making in the palliative brain radiotherapy setting. PATIENTS AND METHODS: Data from 61 consecutive patients were analysed. In addition to Karnofsky Performance Status (KPS) their physical activity was assessed by means of the activity of daily living (ADL) and instrumental ADL (IADL) scales. A neurocognitive evaluation was performed with the Pfeiffer Short Portable Mental Status Questionnaire (SPMSQ) and with the Mini-Mental Status Exam (MMSE). Radiotherapy compliance and short survival were the endpoints of the study. RESULTS: High rates of cognitive impairment were found by both neurocognitive tools (Pfeiffer: 19.7% of patients; MMSE: 30%). Dependence was also highly prevalent, either measured by the ADL (50.8%) or by the IADL (43.3%). Nearly one third (27.9%) of patients died soon after radiotherapy evaluation. Longer survival was related to female, younger than 60 years, breast cancer primary tumour, steroid response, RPA class, and higher performance and neurocognitive score tools. A premature death was associated with neurocognitive tools, IADL and longer interval from brain metastatic diagnosis to radiotherapy. Twenty-three percent of patients were not able to finish the WBRT course due to clinical deterioration. The only variable related to compliance was a low MMSE score. CONCLUSIONS: Results suggest that the geriatric tools analysed could offer information on brain palliative radiotherapy complementary to that offered by the more usual tools. It will be interesting to study if our data could be extrapolated to the general palliative oncological field.
OBJECTIVE: Brain radiotherapy is the main treatment for patients with brain metastases but its goal is just symptom control. Our aim was to study if different performance tools, used in geriatric practice, could improve patient selection for decision-making in the palliative brain radiotherapy setting. PATIENTS AND METHODS: Data from 61 consecutive patients were analysed. In addition to Karnofsky Performance Status (KPS) their physical activity was assessed by means of the activity of daily living (ADL) and instrumental ADL (IADL) scales. A neurocognitive evaluation was performed with the Pfeiffer Short Portable Mental Status Questionnaire (SPMSQ) and with the Mini-Mental Status Exam (MMSE). Radiotherapy compliance and short survival were the endpoints of the study. RESULTS: High rates of cognitive impairment were found by both neurocognitive tools (Pfeiffer: 19.7% of patients; MMSE: 30%). Dependence was also highly prevalent, either measured by the ADL (50.8%) or by the IADL (43.3%). Nearly one third (27.9%) of patients died soon after radiotherapy evaluation. Longer survival was related to female, younger than 60 years, breast cancer primary tumour, steroid response, RPA class, and higher performance and neurocognitive score tools. A premature death was associated with neurocognitive tools, IADL and longer interval from brain metastatic diagnosis to radiotherapy. Twenty-three percent of patients were not able to finish the WBRT course due to clinical deterioration. The only variable related to compliance was a low MMSE score. CONCLUSIONS: Results suggest that the geriatric tools analysed could offer information on brain palliative radiotherapy complementary to that offered by the more usual tools. It will be interesting to study if our data could be extrapolated to the general palliative oncological field.
Authors: May N Tsao; Nancy S Lloyd; Rebecca K S Wong; Eileen Rakovitch; Edward Chow; Normand Laperriere Journal: Cancer Treat Rev Date: 2005-06 Impact factor: 12.111
Authors: Paolo Maione; Francesco Perrone; Ciro Gallo; Luigi Manzione; FrancoVito Piantedosi; Santi Barbera; Silvio Cigolari; Francesco Rosetti; Elena Piazza; Sergio Federico Robbiati; Oscar Bertetto; Silvia Novello; Maria Rita Migliorino; Adolfo Favaretto; Mario Spatafora; Francesco Ferraù; Luciano Frontini; Alessandra Bearz; Lazzaro Repetto; Cesare Gridelli; Emiddio Barletta; Maria Luisa Barzelloni; Rosario Vincenzo Iaffaioli; Ermelinda De Maio; Massimo Di Maio; Gianfranco De Feo; Giuseppe Sigoriello; Paolo Chiodini; Angela Cioffi; Vincenzo Guardasole; Valentina Angelini; Antonio Rossi; Domenico Bilancia; Domenico Germano; Alfredo Lamberti; Vittorio Pontillo; Luigi Brancaccio; Francesco Renda; Francesco Romano; Gabriella Esani; Anna Gambaro; Orazio Vinante; Giuseppe Azzarello; Maurizia Clerici; Roberto Bollina; Paolo Belloni; Mirella Sannicolò; Libero Ciuffreda; Giuseppe Parello; Mary Cabiddu; Cosimo Sacco; Angela Sibau; Gianfranco Porcile; Federico Castiglione; Oliviero Ostellino; Silvio Monfardini; Micaela Stefani; Giorgio Scagliotti; Giovanni Selvaggi; Filippo De Marinis; Olga Martelli; Giampietro Gasparini; Alessandro Morabito; Domenico Gattuso; Giuseppe Colucci; Domenico Galetta; Francesco Giotta; Vittorio Gebbia; Nicola Borsellino; Antonio Testa; Emilia Malaponte; Matteo A Capuano; Michele Angiolillo; Francesco Sollitto; Umberto Tirelli; Simona Spazzapan; Vincenzo Adamo; Giuseppe Altavilla; Antonio Scimone; Maria Raffaella Hopps; Francesco Tartamella; Giovanni Pietro Ianniello; Vincenza Tinessa; Giuseppe Failla; Roberto Bordonaro; Nicola Gebbia; Maria Rosaria Valerio; Modesto D'Aprile; Enzo Veltri; Maurizio Tonato; Samir Darwish; Sante Romito; Francesco Carrozza; Sandro Barni; Antonio Ardizzoia; Giuliana Mara Corradini; Gianfranco Pavia; Mario Belli; Giuseppe Colantuoni; Enzo Galligioni; Orazio Caffo; Roberto Labianca; Antonello Quadri; Enrico Cortesi; Giuliana D'Auria; Sergio Fava; Anna Calcagno; Gino Luporini; M Cristina Locatelli; Francesco Di Costanzo; Silvia Gasperoni; Luciano Isa; Paola Candido; Fernando Gaion; Giovanni Palazzolo; Giuseppe Nettis; Anselmo Annamaria; Massimo Rinaldi; Massimo Lopez; Raffaella Felletti; Giorgio Bernabò Di Negro; Nestore Rossi; Antonio Calandriello; Luigi Maiorino; Rodolfo Mattioli; Alfredo Celano; Stefania Schiavon; Alfonso Illiano; Carlo Alberto Raucci; Michele Caruso; Paolo Foa; Giuseppe Tonini; Carlo Curcio; Marina Cazzaniga Journal: J Clin Oncol Date: 2005-10-01 Impact factor: 44.544
Authors: Christina A Meyers; Jennifer A Smith; Andrea Bezjak; Minesh P Mehta; James Liebmann; Tim Illidge; Ian Kunkler; Jean-Michel Caudrelier; Peter D Eisenberg; Jacobus Meerwaldt; Ross Siemers; Christian Carrie; Laurie E Gaspar; Walter Curran; See-Chun Phan; Richard A Miller; Markus F Renschler Journal: J Clin Oncol Date: 2004-01-01 Impact factor: 44.544
Authors: Minesh P Mehta; Patrick Rodrigus; C H J Terhaard; Aroor Rao; John Suh; Wilson Roa; Luis Souhami; Andrea Bezjak; Mark Leibenhaut; Ritsuko Komaki; Christopher Schultz; Robert Timmerman; Walter Curran; Jennifer Smith; See-Chun Phan; Richard A Miller; Markus F Renschler Journal: J Clin Oncol Date: 2003-07-01 Impact factor: 44.544