Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Expert Rev Pharmacoecon Outcomes Res. 2011 Dec;11(6):693-700. doi: 10.1586/erp.11.66.
Brain metastases occur in approximately 20-40% of cancer patients during the course of disease. As treatment for brain metastases is palliative over curative, quality of life (QoL) is emphasized over prolonged survival. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-BN20 is a QoL assessment specific to brain neoplasms. We aim to provide a review of the current use of the EORTC QLQ-BN20 for patients with brain metastases.
MATERIALS & METHODS: All studies utilizing the QLQ-BN20 for QoL assessment in patients receiving treatments related to brain metastases were included. Study information including treatment type, assessment periods, patient enrolment and all information pertaining to the QLQ-BN20 were extracted.
A total of 13 studies were identified, five of which were randomized trials assessing prophylactic whole brain radiation for patients with small-cell lung cancer. The QLQ-BN20 was used in conjunction with the core QLQ-C30 questionnaire in all but one of the studies and together these comprised the entire QoL assessments for 11 of the 13 studies. Neurocognitive function assessments supplemented QoL in four studies and accompanying performance status indices used with the QLQ-BN20 varied. Compliance issues were commonly cited. QoL changes during study periods varied as improvements, deteriorations and stabilizations were all observed.
QoL assessments should be conducted using disease-specific tools. Future studies should minimize patient burden in order to maximize data collection and accrual. A common set of QoL end points for patients with brain metastases should be created.
在疾病过程中，约有 20-40%的癌症患者会发生脑转移。由于脑转移的治疗是姑息性的，而不是治愈性的，因此生活质量（QoL）比延长生存时间更为重要。欧洲癌症研究与治疗组织（EORTC）的 QLQ-BN20 是一种专门针对脑肿瘤的 QoL 评估工具。我们旨在对目前使用 EORTC QLQ-BN20 评估脑转移患者 QoL 的情况进行综述。
所有使用 QLQ-BN20 评估与脑转移治疗相关的患者 QoL 的研究均被纳入。研究信息包括治疗类型、评估期、患者入组以及与 QLQ-BN20 相关的所有信息。
共确定了 13 项研究，其中 5 项为评估小细胞肺癌患者预防性全脑放疗的随机试验。除了一项研究外，所有研究均将 QLQ-BN20 与核心 QLQ-C30 问卷一起使用，其中 11 项研究的整个 QoL 评估都使用了这两个问卷。四项研究中神经认知功能评估补充了 QoL，与 QLQ-BN20 一起使用的伴随的体能状态指数各不相同。常提到的是合规性问题。研究期间 QoL 的变化各不相同，既有改善，也有恶化和稳定。
应使用疾病特异性工具进行 QoL 评估。未来的研究应尽量减少患者的负担，以最大限度地收集和积累数据。应创建一套针对脑转移患者的常见 QoL 终点。
