Stereotactic radiosurgery improves HRQOL of patients with brain metastases

Patients who underwent stereotactic radiosurgery (SRS) report better post-treatment health-related quality of life (HRQOL) than those who received brain radiotherapy (RT) and systemic therapy, a study has shown. Melanoma metastases, nonmarried, male, and older patients have also conveyed an improved HRQOL in various domains following intracranial RT.

In this study, patients with brain metastases completed overall (European Organisation for Research and Treatment of Cancer QLQ C15-PAL) and brain tumour-specific (QLQ-BN20) assessments of HRQOL prior to RT (n=127) and at 1 (n=56) and 3 months (n=45) after RT.

The authors generated linear and proportional-odds models to analyse patient, disease, and treatment predictors of baseline, 1-, and 3-month HRQOL scores. They also assessed the predictors of longitudinal HRQOL scores using generalized estimating equations and repeated measures proportional-odds models.

Of the patients, 69.3 percent underwent SRS and 36.0 percent had nonsmall-cell lung metastases. Receipt of whole brain RT correlated with a higher likelihood of appetite loss (baseline: p=0.04; 1 month: p=0.02) and greater motor dysfunction (baseline: p=0.01; 1 month: p=0.003; 3 months: p=0.02) compared with SRS.

In addition, receipt of systemic therapy correlated with better emotional functioning post-RT (1 month: p=0.03; 3 months: p=0.01).

Patients with melanoma had higher odds of better global HRQOL (p=0.01) and less pain (p=0.048) than those with brain cancer, while lung cancer patients reported lower physical function (p=0.048) 3 months after RT.

Furthermore, nonmarried patients had a higher likelihood of better global HRQOL (1 month: p=0.01), while male patients had a lower probability of reporting more hair loss (baseline: p=0.03; 3 months: p=0.045). In addition, older patients (aged ≥60 years) had lower chances of more drowsiness (p=0.04) and pain (p=0.049) over time.