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SPCR-07 REDEFINING BOUNDARIES: STEREOTACTIC RADIOSURGERY FOR ENHANCED QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH 5-20 BRAIN METASTASES
INTRODUCTION: Brain metastases (BMs) occur in 10-30% of adult patients with cancer. The therapeutic approach for BMs depends on several factors including lesion number, location and size, primary cancer type, and the patient’s overall health. ASCO-SNO-ASTRO guidelines conditionally recommend stereot...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10402386/ http://dx.doi.org/10.1093/noajnl/vdad070.106 |
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author | Cialdella, Fia van Grinsven, Eva van der Boog, Arthur Nagtegaal, Steven Smid, Ernst Claes, An Kleynen, Karin Seravalli, Enrica Philippens, Marielle van Zandvoort, Martine Verhoeff, Joost |
author_facet | Cialdella, Fia van Grinsven, Eva van der Boog, Arthur Nagtegaal, Steven Smid, Ernst Claes, An Kleynen, Karin Seravalli, Enrica Philippens, Marielle van Zandvoort, Martine Verhoeff, Joost |
author_sort | Cialdella, Fia |
collection | PubMed |
description | INTRODUCTION: Brain metastases (BMs) occur in 10-30% of adult patients with cancer. The therapeutic approach for BMs depends on several factors including lesion number, location and size, primary cancer type, and the patient’s overall health. ASCO-SNO-ASTRO guidelines conditionally recommend stereotactic radiosurgery (SRS) for 1-10 BMs. The aim of this study was to investigate the outcomes of radiotherapy in patients with 5 or more BMs using SRS. METHODS: We implemented the prospective Cohort for patient-reported Outcomes, Imaging and trial inclusion in Metastatic BRAin disease (COIMBRA) to examine all patients with BM(s) who underwent radiotherapy. In this sub-study we investigated overall survival (OS) and health related quality of life (HRQoL) for 47 patients with 5 to 20 BMs. We evaluated patients’ HRQoL using the EQ5D-VAS, at baseline and at 3 monthly intervals after radiotherapy. RESULTS: Median OS was 21.3 months for patients with 5-10 BMs (n=38) and 12.5 months for patients with >10 BMs (n=9). Questionnaires at both baseline and 6 months after radiotherapy showed stability or improvement on the EQ5D-VAS after radiotherapy in 58.1%. Additionally, independence in self-care was not limited before or after SRS. Also, the proportion of patients (66.7%) reporting no limitation on their ability to do daily activities remained stable after radiotherapy. Fewer patients reported pain or other discomfort after SRS compared to before (25% vs 40%). CONCLUSION: Our findings suggest that radiotherapy may improve QoL in patients with 5-20 BMs. Furthermore, compared to the literature, we observed a prolonged OS in this prospective cohort, suggesting that SRS should be considered as the treatment option for these patients. These results highlight the need for further investigation of the role of SRS instead of Whole Brain Radiotherapy (WBRT) in the management of patients with multiple BMs. |
format | Online Article Text |
id | pubmed-10402386 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-104023862023-08-05 SPCR-07 REDEFINING BOUNDARIES: STEREOTACTIC RADIOSURGERY FOR ENHANCED QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH 5-20 BRAIN METASTASES Cialdella, Fia van Grinsven, Eva van der Boog, Arthur Nagtegaal, Steven Smid, Ernst Claes, An Kleynen, Karin Seravalli, Enrica Philippens, Marielle van Zandvoort, Martine Verhoeff, Joost Neurooncol Adv Final Category: Supportive Care/Health Outcomes INTRODUCTION: Brain metastases (BMs) occur in 10-30% of adult patients with cancer. The therapeutic approach for BMs depends on several factors including lesion number, location and size, primary cancer type, and the patient’s overall health. ASCO-SNO-ASTRO guidelines conditionally recommend stereotactic radiosurgery (SRS) for 1-10 BMs. The aim of this study was to investigate the outcomes of radiotherapy in patients with 5 or more BMs using SRS. METHODS: We implemented the prospective Cohort for patient-reported Outcomes, Imaging and trial inclusion in Metastatic BRAin disease (COIMBRA) to examine all patients with BM(s) who underwent radiotherapy. In this sub-study we investigated overall survival (OS) and health related quality of life (HRQoL) for 47 patients with 5 to 20 BMs. We evaluated patients’ HRQoL using the EQ5D-VAS, at baseline and at 3 monthly intervals after radiotherapy. RESULTS: Median OS was 21.3 months for patients with 5-10 BMs (n=38) and 12.5 months for patients with >10 BMs (n=9). Questionnaires at both baseline and 6 months after radiotherapy showed stability or improvement on the EQ5D-VAS after radiotherapy in 58.1%. Additionally, independence in self-care was not limited before or after SRS. Also, the proportion of patients (66.7%) reporting no limitation on their ability to do daily activities remained stable after radiotherapy. Fewer patients reported pain or other discomfort after SRS compared to before (25% vs 40%). CONCLUSION: Our findings suggest that radiotherapy may improve QoL in patients with 5-20 BMs. Furthermore, compared to the literature, we observed a prolonged OS in this prospective cohort, suggesting that SRS should be considered as the treatment option for these patients. These results highlight the need for further investigation of the role of SRS instead of Whole Brain Radiotherapy (WBRT) in the management of patients with multiple BMs. Oxford University Press 2023-08-04 /pmc/articles/PMC10402386/ http://dx.doi.org/10.1093/noajnl/vdad070.106 Text en © The Author(s) 2023. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Final Category: Supportive Care/Health Outcomes Cialdella, Fia van Grinsven, Eva van der Boog, Arthur Nagtegaal, Steven Smid, Ernst Claes, An Kleynen, Karin Seravalli, Enrica Philippens, Marielle van Zandvoort, Martine Verhoeff, Joost SPCR-07 REDEFINING BOUNDARIES: STEREOTACTIC RADIOSURGERY FOR ENHANCED QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH 5-20 BRAIN METASTASES |
title | SPCR-07 REDEFINING BOUNDARIES: STEREOTACTIC RADIOSURGERY FOR ENHANCED QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH 5-20 BRAIN METASTASES |
title_full | SPCR-07 REDEFINING BOUNDARIES: STEREOTACTIC RADIOSURGERY FOR ENHANCED QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH 5-20 BRAIN METASTASES |
title_fullStr | SPCR-07 REDEFINING BOUNDARIES: STEREOTACTIC RADIOSURGERY FOR ENHANCED QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH 5-20 BRAIN METASTASES |
title_full_unstemmed | SPCR-07 REDEFINING BOUNDARIES: STEREOTACTIC RADIOSURGERY FOR ENHANCED QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH 5-20 BRAIN METASTASES |
title_short | SPCR-07 REDEFINING BOUNDARIES: STEREOTACTIC RADIOSURGERY FOR ENHANCED QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH 5-20 BRAIN METASTASES |
title_sort | spcr-07 redefining boundaries: stereotactic radiosurgery for enhanced quality of life and survival in patients with 5-20 brain metastases |
topic | Final Category: Supportive Care/Health Outcomes |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10402386/ http://dx.doi.org/10.1093/noajnl/vdad070.106 |
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