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A cohort study on effect of whole brain...
Journal article

A cohort study on effect of whole brain radiotherapy in patients with brain metastases from solid cancers

Abstract

Background: Whole brain radiotherapy (WBRT) is known to improve tumor control and survival over best supportive care. However, conflicting evidence exists regarding its effect on patient-rated symptoms and quality of life. Objectives: To evaluate the change in the patient self-reported symptoms, overall survival, change in use of steroids and Karnofsky performance status (KPS) with WBRT for brain metastases from solid cancers. Methods: This is a single center, prospective observational cohort study, with patients recruited between March and September 2015. A self-designed 9-item symptom checklist was conducted at baseline, 1 month and 3 months following WBRT to evaluate changes in symptom score. Results: 19 patients were recruited, with a median age of 66 (range 30-89) and median KPS was 70 (range 40-100); most (85%) had lung cancer. The mean scores of most symptoms (except nausea, fatigue and limb weakness) either remained static or decreased with time after WBRT, At 3 months, about half (45%) of patients tapered off their use of steroids and the majority (80%) had stable or improved performance status. The median overall survival was 4.6 months (range 3.8-5.4 months). Conclusion: WBRT appears to stabilize most symptoms, except nausea, fatigue and limb weakness. It also appears to prevent neurological deterioration while allowing tapering of use of steroids. Overall life expectancy remained short (few months), given most deaths are attributed to extracranial disease progression. Further investigations are warranted to identify patient subgroups which would benefit most from WBRT.

Authors

Ying FLM; Ka Yan RW; Lui LC; Yuk Ting ML; Agarwal A

Journal

Journal of Pain Management, Vol. 11, No. 1, pp. 41–52

Publication Date

January 1, 2018

ISSN

1939-5914

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