Impact of Palliative Radiotherapy on Quality of Life in Patients with Bone vs. Non-Bone Lesions: Secondary Analysis of a Prospective Study.

IF 6.5 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics Pub Date : 2025-10-10 DOI:10.1016/j.ijrobp.2025.09.055

Yutaro Koide, Kenta Nimura, Masamune Noguchi, Tomoki Kitagawa, Takahiro Aoyama, Shingo Hashimoto, Hiroyuki Tachibana, Takeshi Kodaira

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引用次数: 0

Abstract

Purpose: This study compared quality-of-life (QoL) changes following palliative radiation therapy (RT) between patients with painful bone metastases and those with painful non-bone lesions.

Methods and materials: A total of 440 patients with 678 lesions (541 bone metastases and 137 non-bone lesions) who underwent palliative RT between 2021 and 2023 were included, using the same cohort as a previous study assessing pain response. From 2756 QLQ-C15-PAL/BM22 questionnaires collected simultaneously with pain assessments, mean scores for each C15-PAL subscale at baseline and 2, 4, and 12 weeks post-RT were analyzed. The primary endpoint was the difference in mean change in GHS/QoL scores from baseline to 12 weeks between the groups. Secondary endpoints included the differences in other subscales and the improvement rates in each subscale.

Results: The median follow-up time was 21 weeks for pain response and 13 weeks for QoL. Baseline QoL data were available for 97% (656/678) of lesions and 74% (338/458) at 12 weeks, with no significant difference between the groups. At baseline, the non-bone group had better GHS/QoL (45 vs. 39, P = .015) and physical functioning (76 vs. 67, P = .02), but slightly worse scores in the pain subscale (52 vs. 51, P = .005). At 12 weeks, no significant differences were observed between the groups across all QoL subscales, including GHS/QoL (52 vs. 49, P = .41). Regarding changes over time, dyspnea worsened in the bone metastasis group (+9 vs. +1, P = .017), while changes in GHS/QoL (+5 vs. +1, P = .27) and other subscales were not significantly different. Improvement rates across all subscales, including GHS/QoL (39% vs. 48%, P = .44), were not significantly different between groups.

Conclusions: The results of this study indicate that QoL changes after palliative RT for non-bone lesions are comparable to those for bone metastases, providing a basis for future development in this underexplored area.

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姑息放疗对骨与非骨病变患者生活质量的影响：一项前瞻性研究的二次分析。

目的：本研究比较疼痛性骨转移患者和疼痛性非骨病变患者在姑息性放射治疗（RT）后的生活质量（QoL）变化。方法和材料：在2021年至2023年期间接受姑息性放疗的440例患者共678例病变（541例骨转移和137例非骨病变），使用与先前评估疼痛反应的研究相同的队列。从与疼痛评估同时收集的2756份QLQ-C15-PAL/BM22问卷中，分析每个C15-PAL子量表在基线和rt后2、4和12周的平均得分。主要终点是两组从基线到12周GHS/QoL评分的平均变化差异。次要终点包括其他亚量表的差异和每个亚量表的改善率。结果：疼痛缓解的中位随访时间为21周，生活质量的中位随访时间为13周。12周时，97%（656/678）病变和74%（338/458）病变的基线生活质量数据可获得，两组间无显著差异。在基线时，非骨组的GHS/QoL更好（45比39，P = ）。015)和身体功能(76比67，P = 。02)，但疼痛分量表得分稍差（52比51，P = .005）。在12周时，各组之间在所有生活质量亚量表上均无显著差异，包括GHS/QoL（52对49，P = .41）。随着时间的变化，骨转移组呼吸困难加重（+9 vs +1, P = ）。017)，而GHS/QoL的变化(+5 vs +1, P = 。27)和其他分量表差异不显著。所有子量表的改善率，包括GHS/QoL （39% vs 48%, P = ）。44)，组间差异无统计学意义。结论：本研究结果表明，非骨病变姑息性放疗后的生活质量变化与骨转移后的生活质量变化相当，为该领域的进一步发展提供了基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Radiation Oncology Biology Physics 医学-核医学

CiteScore

11.00

自引率

7.10%

发文量

2538

审稿时长

6.6 weeks

期刊介绍： International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field. This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.