TY  - JOUR
A1  - Steinmann, Diana
A1  - Paelecke-Habermann, Yvonne
A1  - Geinitz, Hans
A1  - Aschoff, Raimund
A1  - Bayerl, Anja
A1  - Bölling, Tobias
A1  - Bosch, Elisabeth
A1  - Bruns, Frank
A1  - Eichenseder-Seiss, Ute
A1  - Gerstein, Johanna
A1  - Gharbi, Nadine
A1  - Hagg, Juliane
A1  - Hipp, Matthias
A1  - Kleff, Irmgard
A1  - Müller, Axel
A1  - Schäfer, Christof
A1  - Schleicher, Ursula
A1  - Sehlen, Susanne
A1  - Theodorou, Marilena
A1  - Wypior, Hans-Joachim
A1  - Zehentmayr, Franz
A1  - van Oorschot, Birgitt
A1  - Vordermark, Dirk
T1  - Prospective evaluation of quality of life effects in patients undergoing palliative radiotherapy for brain metastases
JF  - BMC Cancer
N2  - Background: Recently published results of quality of life (QoL) studies indicated different outcomes of palliative radiotherapy for brain metastases. This prospective multi-center QoL study of patients with brain metastases was designed to investigate which QoL domains improve or worsen after palliative radiotherapy and which might provide prognostic information. 
Methods: From 01/2007-01/2009, n=151 patients with previously untreated brain metastases were recruited at 14 centers in Germany and Austria. Most patients (82 %) received whole-brain radiotherapy. QoL was measured with the EORTC-QLQ-C15-PAL and brain module BN20 before the start of radiotherapy and after 3 months. 
Results: At 3 months, 88/142 (62 %) survived. Nine patients were not able to be followed up. 62 patients (70.5 % of 3-month survivors) completed the second set of questionnaires. Three months after the start of radiotherapy QoL deteriorated significantly in the areas of global QoL, physical function, fatigue, nausea, pain, appetite loss, hair loss, drowsiness, motor dysfunction, communication deficit and weakness of legs. Although the use of corticosteroid at 3 months could be reduced compared to pre-treatment (63 % vs. 37 %), the score for headaches remained stable. Initial QoL at the start of treatment was better in those alive than in those deceased at 3 months, significantly for physical function, motor dysfunction and the symptom scales fatigue, pain, appetite loss and weakness of legs. In a multivariate model, lower Karnofsky performance score, higher age and higher pain ratings before radiotherapy were prognostic of 3-month survival. 
Conclusions: Moderate deterioration in several QoL domains was predominantly observed three months after start of palliative radiotherapy for brain metastases. Future studies will need to address the individual subjective benefit or burden from such treatment. Baseline QoL scores before palliative radiotherapy for brain metastases may contain prognostic information.
KW  - breast cancer
KW  - brain tumours
KW  - survival
KW  - validation
KW  - symptoms
KW  - EORTC-QLQ-C15-PAL
KW  - EORTC-BN20
KW  - whole-brain radiotherapy
KW  - partitioning analysis RPA
KW  - cancer patients
KW  - lung cancer
KW  - prognostic index
KW  - radiation oncology
KW  - clinical trials
Y1  - 2012
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-135254
VL  - 12
IS  - 283
ER  -