Diana Steinmann1, Dirk Vordermark2, Wiebke Gerstenberg3,4, Raimund Aschoff5, Nadine Gharbi6,7, Axel Müller6, Christof Schäfer8, Marilena Theodorou6, Hans-Joachim Wypior9, Hans Geinitz10. 1. Department of Radiotherapy and Special Oncology, Medical School Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Steinmann.Diana@mh-hannover.de. 2. Department of Radiation Oncology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany. 3. Department of Radiotherapy and Special Oncology, Medical School Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. 4. Department for Dermatology and Allergology, Helios Klinikum Berlin-Buch, Berlin, Germany. 5. Strahlentherapie 360°, Praxis am Sana-Klinikum Duisburg, Duisburg, Germany. 6. Department of Radiation Oncology, TU München, Munich, Germany. 7. Medical Faculty, Department of Radiation Oncology, CyberKnife- and Radiation Therapy, University of Cologne, Cologne, Germany. 8. Department of Radiation Oncology, St. Elisabeth Hospital Straubing, Straubing, Germany. 9. Department of Radiation Oncology, Hospital Landshut, Landshut, Germany. 10. Department of Radiation Oncology, Krankenhaus Barmherzige Schwestern Linz and Medical Faculty, Johannes Kepler University Linz, Linz, Austria.
Abstract
PURPOSE: Published results of quality of life (QoL) studies mostly concern whole brain radiotherapy for limited or multiple brain metastases. This prospective multicentre study was designed to compare the QoL of patients with limited (1-3) brain metastases treated with either whole brain (WBRT) or stereotactic radiotherapy (SRT). METHODS: From 01/2007-03/2011, 90 limited brain metastases patients who were previously untreated (n = 77) or had undergone primary surgery (n = 13) were recruited at 14 centres in Germany and Austria. QoL was measured with the EORTC-QLQ-C15-PAL and BN20 brain modules before the start of radiotherapy and after 3 months. RESULTS: Fifty-two patients (58%) received WBRT and 38 (42%) received SRT. At 3 months, 67 patients (74%) were still living, and 92.6% of the 3‑month survivors completed the second set of questionnaires. Analysis of the QLQ-C15-PAL and BN20 scales revealed significant deterioration in patients treated with WBRT and SRT in physical function (p < 0.001 and p = 0.007), fatigue (p < 0.001 and p = 0.036), nausea (p = 0.003 and p = 0.002), appetite loss (p < 0.001 and p = 0.025), drowsiness (p < 0.001 and p = 0.011), hair loss (p = 0.019 and p = 0.023) and itchy skin (p = 0.030 and p = 0.018). Motor dysfunction (p < 0.001), communication deficits (p = 0.002) and leg weakness (p < 0.001) declined significantly only in patients treated with WBRT. Comparing the two radiotherapy techniques over time, the results showed significant differences in symptom scores for future uncertainty, fatigue and appetite loss. CONCLUSIONS: QoL data as an outcome of the paper should be considered in decision making on the irradiation technique in patients with small number of brain metastases. Larger studies are required to verify the results according to subgroups.
PURPOSE: Published results of quality of life (QoL) studies mostly concern whole brain radiotherapy for limited or multiple brain metastases. This prospective multicentre study was designed to compare the QoL of patients with limited (1-3) brain metastases treated with either whole brain (WBRT) or stereotactic radiotherapy (SRT). METHODS: From 01/2007-03/2011, 90 limited brain metastasespatients who were previously untreated (n = 77) or had undergone primary surgery (n = 13) were recruited at 14 centres in Germany and Austria. QoL was measured with the EORTC-QLQ-C15-PAL and BN20 brain modules before the start of radiotherapy and after 3 months. RESULTS: Fifty-two patients (58%) received WBRT and 38 (42%) received SRT. At 3 months, 67 patients (74%) were still living, and 92.6% of the 3‑month survivors completed the second set of questionnaires. Analysis of the QLQ-C15-PAL and BN20 scales revealed significant deterioration in patients treated with WBRT and SRT in physical function (p < 0.001 and p = 0.007), fatigue (p < 0.001 and p = 0.036), nausea (p = 0.003 and p = 0.002), appetite loss (p < 0.001 and p = 0.025), drowsiness (p < 0.001 and p = 0.011), hair loss (p = 0.019 and p = 0.023) and itchy skin (p = 0.030 and p = 0.018). Motor dysfunction (p < 0.001), communication deficits (p = 0.002) and leg weakness (p < 0.001) declined significantly only in patients treated with WBRT. Comparing the two radiotherapy techniques over time, the results showed significant differences in symptom scores for future uncertainty, fatigue and appetite loss. CONCLUSIONS: QoL data as an outcome of the paper should be considered in decision making on the irradiation technique in patients with small number of brain metastases. Larger studies are required to verify the results according to subgroups.
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