Prospective assessment of quality of life in patients with brain metastasis receiving whole brain radiotherapy.

Abstract

Background: Palliative whole brain radiotherapy (WBRT) is an important cornerstone for the management of brain metastasis. WBRT alleviates symptoms, aiding in tapering of steroid dose. Thus, the assessment of quality of life (QoL) has become increasingly recognized as an important outcome in patients with brain metastasis. The primary objective of this study was to assess whether there was an improvement in QoL for patients with brain metastasis after radiation therapy and to evaluate the feasibility of application of shorter QoL assessment methods.

Methods: This prospective observational study included 84 patients treated for brain metastasis. QoL assessments were conducted at baseline and three months after completion of WBRT. QoL assessment was done with EORTC QOL-C15-PAL, EORTC QOL-BN20 module and Barthel index for Activities of Daily Living. Statistical analysis was done using SPSS version 21, paired sample t-tests and Spearman's correlation.

Results: The median age was 59 years (range 37-81 years). Statistically significant improvement was seen in Barthel index at three months follow-up. For C-15-PAL and BN20 questionnaires, there was a statistically significant improvement seen in the majority of post therapy QoL scores. Baseline KPS was positively correlated with baseline Barthel index, C-15PAL physical functioning scale and baseline global QoL scale, but it negatively correlated with baseline QLQ-BN20 motor dysfunction scale. Baseline KPS was positively correlated with follow-up QLQ-C15-PAL physical functioning scale.

Conclusion: Palliative therapy with WBRT for brain metastasis forms an integral support for improved quality of life. Among various assessment tools available, the shorter versions allow for better completion and compliance.