Quality of life result from a randomized trial that compared WBRT
with radiosurgery of tumor cavity
Lucyna
1,
2
Kepka ,
3
Tyc-Szczepaniak ,
1
Osowiecka ,
4,3
Sprawka ,
Dobromira
Karolina
Arkadiusz
Berenika Trąbska-Kluch5, Beata Czeremszyńska1, Marta Olszyna-Serementa3
1Independent
Public Health Care Facility and Warmian & Mazurian Oncology Center, Olsztyn; 2Military Institute of Medicine, Warsaw;
3M.Sklodowska-Curie Memorial Oncology Center and Institute of Oncology, Warsaw; 4Centre of Oncological Diagnostics and Therapy, Tomaszów
Mazowiecki; 5Medical University of Łódź, Łódź;
Poland
OBJECTIVES
METHODS
• Our recently published randomized trial (NCT01535209)
demonstrated no difference in neurocognitive function
between stereotactic radiotherapy of the tumor bed
(SRT-TB) (15Gy/1 fraction or 25Gy/5 fractions) and
whole brain radiotherapy (WBRT) (30Gy/10fractions) in
patients with resected single brain metastasis.
Additionally, patients treated with SRT-TB had lower
overall survival compared with WBRT arm due to the
excess of neurological deaths.
• Because not demonstrated differences in neurological
and cognitive functioning between both arms it may be
supposed that differences in health-related quality of life
(HR-QOL) will likewise not be found between patients
receiving WBRT and those treated with omission of upfront WBRT. Better intracranial control with WBRT in our
trial would compensate for the neurocognitive toxicity of
this method. However, there are some areas of
functioning that may be compromised by the toxicity of
WBRT despite its beneficial effect on improved
intracranial control.
• Thus, in the present study, we aimed to evaluate the
results of prospectively collected questionnaires on
HR-QOL in patients who received up-front WBRT
after surgery and those who had SRT-TB only
•A self-assessed questionnaire was used to assess the HR-QOL (EORTC QLQC30 with -BN20 module) at baseline prior to RT, two and five months after RT.
HR-QOL results were presented as mean scores and compared between arms
at the principle of the treatment actually given and time points using the
Wilcoxon rank sum test.
•Figure 1 shows accrual flow of the trial
and patients’ compliance in filling HRQOL
questionnaires.
RESULTS
• Of 59 randomized patients, 37 (64%) were eligible for
HRQOL analysis; 15 received SRT-TB and 22 had
WBRT.
COMPARISON BETWEEN ARMS
• There was no difference in global health status, main
function scales/symptoms (except for drowsiness which
was worse in WBRT arm 2 months after RT [p=0.048])
between arms.
LONGITUDINAL EVALUATION OF THE CHANGES IN
HRQOL
•
•
•
•
Global health status decreased 2 and 5 months after RT, but
significantly only for SRT-TB (p=0.025).
Physical function decreased significantly 5 months after SRT-TB
(p=0.008).
Future uncertainty worsened after RT, but significantly only for SRT-TB
arm at 2 months (p=0.036).
Patients treated with WBRT had significant worsening of appetite,
drowsiness, and hair loss after treatment. Visual disorders improved
after RT, significantly for WBRT; constipation worsened after RT,
significantly for SRT-TB arm (fig. 3 and 4).
Previous publication of the
main result of this trial
CONCLUSIONS
ESTRO 2017
Despite higher symptoms burden after WBRT that are attributed to the side effects
of RT, like appetite loss, drowsiness, and hair loss, QLQ-C30 global health status,
physical functioning and future uncertainty favored WBRT in comparison with SRTTB in our study.
This may be related to the compromised brain tumor control with omission of
WBRT; however, we should be aware that in brain metastases patients many
factors may influence QoL.
PO-0626
Clinical track: CNS
Lucyna Kepka
DOI: 10.3252/pso.eu.ESTRO36.2017
Poster
presented at: