Quality of Life in Brain Metastases Radiation Trials: A Literature Review

[摘要] Whole brain radiotherapy (WBRT) is the standard treatment for patients with brain metastases. Although WBRT can reduce neurological symptoms, the median survival following WBRT is between 3 and 6 months. With this limited survival, it is important to consider the patients’ quality of life (QOL) when treating patients with brain metastases. A literature review was performed to examine the endpoints used to measure the efficacy of WBRT either alone or in combination with other treatment interventions, and to examine the QOL instruments used in previous brain metastases trials. A total of 61 trials that included WBRT as a treatment of brain metastases were identified. Although 55 of the trials employed a QOL instrument, few trials focused on QOL as an outcome. Twenty-three different instruments were used to evaluate QOL. KPS was the most commonly employed instrument (n=33), followed by various forms of neurological function classification scales (n=21). Previous trials have reported deterioration in QOL after WBRT in patients of poorer prognosis while other trials have seen an improvement in QOL after WBRT in patients of better prognosis. The use of a standard validated QOL instrument for this patient population is lacking which makes comparisons between findings of QOL studies difficult. This review emphasizes the need to include QOL measures in future WBRT clinical trials for brain metastases.

[学科分类] 肿瘤学