Health-related quality of life after stereotactic radiosurgery in patients with brain metastases

Elaine A C Albers; Kelly M de Ligt; Lonneke V van de Poll-Franse; Annette Compter; Michiel B de Ruiter; Sanne B Schagen

doi:10.1007/s00520-023-08203-6

Health-related quality of life after stereotactic radiosurgery in patients with brain metastases

Support Care Cancer. 2023 Nov 27;31(12):720. doi: 10.1007/s00520-023-08203-6.

Authors

Elaine A C Albers¹, Kelly M de Ligt², Lonneke V van de Poll-Franse^{2

3

4}, Annette Compter⁵, Michiel B de Ruiter², Sanne B Schagen^{2

6}

Affiliations

¹ Department of Psychosocial Research, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands. e.albers@nki.nl.
² Department of Psychosocial Research, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands.
³ Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands.
⁴ Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands.
⁵ Department of neuro-oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
⁶ Deparment of Psychology, University of Amsterdam, Amsterdam, The Netherlands.

PMID: 38008876
DOI: 10.1007/s00520-023-08203-6

Abstract

Purpose: This study aimed to assess health-related quality of life (HRQoL) in patients with brain metastases treated with stereotactic radiosurgery (SRS) and to identify factors associated with this.

Methods: HRQoL was measured pre-SRS, at 3- and 6-month follow-up. Physical functioning, cognitive functioning, role functioning, and fatigue were analyzed with the EORTC QLQ-C30 questionnaire. Motor dysfunction, future uncertainty, visual disorder, communication deficit, and headaches were analyzed with the EORTC QLQ-BN20. Clinically important symptom or functional impairment was assessed following set thresholds. Factors associated with impairment were identified through multivariable logistic regression analyses.

Results: At baseline, 178 patients were included; 54% (n=96) completed questionnaires at 3 months and 39% (n=70) at 6 months. Before SRS, 29% of linear accelerator (LINAC) patients reported physical and cognitive impairment, while 25% reported impairment for fatigue. At 6 months, 39%, 43%, and 57% of LINAC patients reported impairment respectively. Forty-five percent of Gamma Knife (GK) patients reported impairment pre-SRS for physical, cognitive functioning, and fatigue. At 6 months, 48%, 43%, and 33% of GK patients reported impairment respectively. Except for role functioning, pre-SRS symptom and functioning scores were associated with impairment at 3 months, whereas scores at 3 months were associated with impairment at 6 months. Age, gender, systemic therapy, and intracranial progression were not associated with clinically important impairment.

Conclusion: As 33-57% of patients with brain metastases reported symptom burden and functional impairments that were of clinical importance, it is recommended to pay attention to the HRQoL outcomes of these patients during clinical encounters.

Keywords: Brain metastases; Gamma Knife radiosurgery; Health-related quality of life; LINAC radiosurgery; Stereotactic radiosurgery.

MeSH terms

Brain Neoplasms* / pathology
Brain Neoplasms* / radiotherapy
Brain Neoplasms* / surgery
Fatigue / epidemiology
Fatigue / etiology
Humans
Particle Accelerators
Quality of Life
Radiosurgery* / adverse effects