Individual changes in neurocognitive functioning and health-related quality of life in patients with brain oligometastases treated with stereotactic radiotherapy

J Neurooncol. 2018 Sep;139(2):359-368. doi: 10.1007/s11060-018-2868-7. Epub 2018 Apr 16.

Abstract

Background: Recently, it has been shown that at group level, patients with limited brain metastases treated with stereotactic radiotherapy (SRT) maintain their pre-treatment levels of neurocognitive functioning (NCF) and health-related quality of life (HRQoL). The aim of this study was to evaluate NCF and HRQoL changes over time at the individual patient level.

Methods: NCF (seven domains assessed with a standardized test battery) and HRQoL (eight predetermined scales assessed with the EORTC QLQ-C30 and BN20 questionnaires) were measured prior to SRT and at 3 and/or 6 months follow-up. Changes in NCF and HRQoL were evaluated at (1) a domain/scale level and (2) patient level.

Results: A total of 55 patients were examined, of which the majority showed stable NCF 3 months after SRT, on both the domain level (78-100% of patients) and patient level (67% of patients). This was different for HRQoL, where deterioration in the different scales was observed in 12-61% of patients, stable scores in 20-71%, and improvement in 16-40%, 3 months after SRT. At patient level, most patients (64%) showed both improvement and deterioration in different HRQoL scales. Results were similar between 3 and 6 months after SRT.

Conclusion: In line with results at group level, most brain oligometastases patients with ≥ 6 months follow-up and treated with SRT maintained their pre-treatment level of NCF during this period. By contrast, changes in HRQoL scores differed considerably at domain and patient level, despite stable HRQoL scores at group level.

Keywords: Brain metastases; Health-related quality of life; Neurocognitive functioning; Stereotactic radiotherapy.

MeSH terms

  • Brain Neoplasms / mortality
  • Brain Neoplasms / psychology
  • Brain Neoplasms / radiotherapy*
  • Brain Neoplasms / secondary*
  • Cognition* / radiation effects
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Quality of Life*
  • Radiosurgery* / adverse effects