Mia Salans1, Anthony Yip1, Jeffrey Burkeen2, Kevin X Liu3, Euyhyun Lee4, Tonya Pan-Weisz5,6, Deborah Marshall7, Susan G R McDuff8, Yasamin Sharifzadeh9, Yoseph Dalia10, Parag Sanghvi1, Daniel Simpson1, Ronghui Xu4, Carrie McDonald1,5, Jona A Hattangadi-Gluth1. 1. Departments of Radiation Medicine and Applied Sciences. 2. Ochsner Medical Center, New Orleans, LA. 3. Harvard Radiation Oncology Program, Harvard Medical School, Boston, MA. 4. Mathematics. 5. Psychiatry, University of California San Diego, La Jolla. 6. Mental Health Service, Veterans Affairs San Diego Healthcare System, San Diego, CA. 7. Icahn School of Medicine at Mount Sinai, New York, NY. 8. Department of Radiation Oncology, Duke Cancer Center, Durham, NC. 9. Virginia Commonwealth School of Medicine, Richmond, VA. 10. Department of Dermatology, The University of Tennesee Health Science Center, Memphis, TN.
Abstract
OBJECTIVE: We conducted a prospective clinical trial of patients receiving radiation (RT) for brain metastases to identify clinical predictors of pre-RT and post-RT health-related quality of life (hrQoL). MATERIALS AND METHODS: Patients with brain metastases completed overall (European Organisation for Research and Treatment of Cancer QLQ C15-PAL) and brain tumor-specific (QLQ-BN20) hrQoL assessments pre-RT (n=127) and 1 (n=56) and 3 (n=45) months post-RT. Linear and proportional-odds models analyzed patient, disease, and treatment predictors of baseline, 1-, and 3-month hrQoL scores. Generalized estimating equations and repeated measures proportional-odds models assessed predictors of longitudinal hrQoL scores. RESULTS: Most patients underwent stereotactic radiosurgery (SRS) (69.3%) and had non-small-cell lung (36.0%) metastases. Compared with SRS, receipt of whole brain RT was associated with a higher odds of appetite loss (baseline P=0.04, 1 mo P=0.02) and greater motor dysfunction (baseline P=0.01, 1 mo P=0.003, 3 mo P=0.02). Receipt of systemic therapy was associated with better emotional functioning after RT (1 mo P=0.03, 3 mo P=0.01). Compared with patients with breast cancer, patients with melanoma had higher odds of better global hrQoL (P=0.01) and less pain (P=0.048), while patients with lung cancer reported lower physical function (P=0.048) 3 months post-RT. Nonmarried patients had greater odds of higher global hrQoL (1 mo P=0.01), while male patients had lower odds of reporting more hair loss (baseline P=0.03, 3 mo P=0.045). Patients 60 years and above had lower odds of more drowsiness (P=0.04) and pain (P=0.049) over time. CONCLUSIONS: Patients receiving SRS versus whole brain RT and systemic therapy reported better posttreatment hrQoL. In addition, melanoma metastases, nonmarried, male, and older patients with reported better hrQoL in various as well as domains after intracranial RT.
OBJECTIVE: We conducted a prospective clinical trial of patients receiving radiation (RT) for brain metastases to identify clinical predictors of pre-RT and post-RT health-related quality of life (hrQoL). MATERIALS AND METHODS: Patients with brain metastases completed overall (European Organisation for Research and Treatment of Cancer QLQ C15-PAL) and brain tumor-specific (QLQ-BN20) hrQoL assessments pre-RT (n=127) and 1 (n=56) and 3 (n=45) months post-RT. Linear and proportional-odds models analyzed patient, disease, and treatment predictors of baseline, 1-, and 3-month hrQoL scores. Generalized estimating equations and repeated measures proportional-odds models assessed predictors of longitudinal hrQoL scores. RESULTS: Most patients underwent stereotactic radiosurgery (SRS) (69.3%) and had non-small-cell lung (36.0%) metastases. Compared with SRS, receipt of whole brain RT was associated with a higher odds of appetite loss (baseline P=0.04, 1 mo P=0.02) and greater motor dysfunction (baseline P=0.01, 1 mo P=0.003, 3 mo P=0.02). Receipt of systemic therapy was associated with better emotional functioning after RT (1 mo P=0.03, 3 mo P=0.01). Compared with patients with breast cancer, patients with melanoma had higher odds of better global hrQoL (P=0.01) and less pain (P=0.048), while patients with lung cancer reported lower physical function (P=0.048) 3 months post-RT. Nonmarried patients had greater odds of higher global hrQoL (1 mo P=0.01), while male patients had lower odds of reporting more hair loss (baseline P=0.03, 3 mo P=0.045). Patients 60 years and above had lower odds of more drowsiness (P=0.04) and pain (P=0.049) over time. CONCLUSIONS: Patients receiving SRS versus whole brain RT and systemic therapy reported better posttreatment hrQoL. In addition, melanoma metastases, nonmarried, male, and older patients with reported better hrQoL in various as well as domains after intracranial RT.
Authors: Holly G Prigerson; Yuhua Bao; Manish A Shah; M Elizabeth Paulk; Thomas W LeBlanc; Bryan J Schneider; Melissa M Garrido; M Carrington Reid; David A Berlin; Kerin B Adelson; Alfred I Neugut; Paul K Maciejewski Journal: JAMA Oncol Date: 2015-09 Impact factor: 31.777
Authors: Alina Sturdza; Barbara-Ann Millar; Neelufer Bana; Normand Laperriere; Gregory Pond; Rebecca K S Wong; Andrea Bezjak Journal: Support Care Cancer Date: 2008-02-07 Impact factor: 3.603