Quality of life among patients with 4 to 10 brain metastases after treatment with whole-brain radiotherapy vs. stereotactic radiotherapy: a phase III, randomized, Dutch multicenter trial.

Autor:	Hartgerink D; Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, The Netherlands., Bruynzeel A; Department of Radiation Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Eekers D; Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, The Netherlands., Swinnen A; Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, The Netherlands., Hurkmans C; Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands., Wiggenraad R; Department of Radiation Oncology, Haaglanden Medical Center, The Hague, The Netherlands., Swaak-Kragten A; Department of Radiation Oncology, Erasmus MC, Rotterdam, The Netherlands., Dieleman E; Department of Radiation Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands., van der Toorn PP; Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands., van Veelen L; Department of Radiation Oncology, Zuid-West Radiotherapy Institute, Vlissingen, The Netherlands., Verhoeff JJC; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands., Lagerwaard F; Department of Radiation Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands., de Ruysscher D; Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, The Netherlands., Lambin P; Department of Precision Medicine, The M-Lab, GROW - School for Oncology and Developmental Biology, Maastricht Comprehensive Cancer Centre, Maastricht University, Maastricht, The Netherlands., Zindler J; Department of Radiation Oncology, Haaglanden Medical Center, The Hague, The Netherlands; Department of Radiotherapy, Holland Proton Therapy Center, Delft, The Netherlands.
Jazyk:	angličtina
Zdroj:	Annals of palliative medicine [Ann Palliat Med] 2022 Apr; Vol. 11 (4), pp. 1197-1209. Date of Electronic Publication: 2021 Nov 18.
DOI:	10.21037/apm-21-1545
Abstrakt:	Background: Stereotactic radiotherapy (SRT) is an attractive treatment option for patients with brain metastases (BM), sparing healthy brain tissue and likely controlling local tumors. Most previous studies have focused on radiological response or survival. Our randomized trial (NCT02353000) investigated whether quality of life (QoL) is better preserved using SRT than whole-brain radiotherapy (WBRT) for patients with multiple BM. Recently, we published our trial's primary endpoints. The current report discusses the study's secondary endpoints. Methods: Patients with 4 to 10 BM were randomly assigned to a standard-arm WBRT (20 Gy in 5 fractions) or SRT group (1 fraction of 15-24 Gy or 3 fractions of 8 Gy). QoL endpoints-such as EQ5D domains post-treatment, the Barthel index, the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires, and the neurocognitive Hopkins Verbal Learning Test-were evaluated. Results: Due to poor accrual resulting from patients' and referrers' preference for SRT, this study closed prematurely. The other endpoints' results were published recently. Twenty patients were available for analysis (n=10 vs. n=10 for the two groups, respectively). Significant differences were observed 3 months post-treatment for the mobility (P=0.041), self-care (P=0.028), and alopecia (P=0.014) EQ5D domains, favoring SRT. This self-care score also persisted compared to the baseline (P=0.025). Multiple EORTC categories reflected significant differences, favoring SRT-particularly physical functioning and social functioning. Conclusions: For patients with multiple BM, SRT alone led to persistently higher QoL than treatment with WBRT. Trial Registration: ClinicalTrials.gov, NCT02353000.
Databáze:	MEDLINE
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