Gamma Knife Center, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
J Cancer Res Clin Oncol. 2021 Apr;147(4):1157-1167. doi: 10.1007/s00432-020-03400-w. Epub 2020 Oct 6.
Increasingly more patients with multiple (> 4) brain metastases (BM) are being treated with stereotactic radiosurgery (SRS). Preserving patients' health-related quality of life (HRQoL) is an important treatment goal. The aim of this study was to assess (individual) changes in HRQoL in patients with 1-10 BM over time.
A total of 92 patients were assessed before (n = 92) and at 3 (n = 66), 6 (n = 53), and 9 (n = 41) months after Gamma Knife radiosurgery (GKRS), using the Functional Assessment of Cancer Therapy-Brain (FACT-Br). The course of HRQoL was analyzed using linear mixed models. Clinical minimally important differences were used to evaluate individual changes.
At group level, patients' physical well-being worsened, whereas emotional well-being improved over 9 months. Scores on other HRQoL subscales did not change significantly. Number (1-3 versus 4-10) and volume (small, medium, and large) of BM did not influence HRQoL over time, except for the subscale additional concerns; medium intracranial tumor volume was associated with less additional concerns. On the individual level as well, physical well-being declined while emotional well-being improved in most patients over 9 months after GKRS. At patient level, however, most patients had both declines as well as improvements in the different HRQoL aspects.
Our results indicate that even in patients with up to 10 BM, both at group and individual subscale level, aspects of HRQoL remained stable over nine months after GKRS, except for an improvement in emotional well-being and a decline in physical well-being. Nevertheless, HRQoL scores varied considerably at the individual patient level.
ClinicalTrials.gov Identifier: NCT02953756, November 3, 2016.
越来越多患有多发（>4 个）脑转移瘤（BM）的患者接受立体定向放射外科（SRS）治疗。维持患者的健康相关生活质量（HRQoL）是一个重要的治疗目标。本研究旨在评估 1-10 个 BM 的患者随时间变化的 HRQoL（个体）变化。
共 92 例患者在伽玛刀放射外科治疗（GKRS）前（n=92）和 3 个月（n=66）、6 个月（n=53）和 9 个月（n=41）后，使用癌症治疗功能评估-脑（FACT-Br）评估 HRQoL。采用线性混合模型分析 HRQoL 变化。使用临床最小重要差异评估个体变化。
在组水平上，患者的身体状况恶化，而情绪状况在 9 个月内得到改善。其他 HRQoL 亚量表的评分没有显著变化。BM 的数量（1-3 个与 4-10 个）和体积（小、中、大）在整个时间内都没有影响 HRQoL，除了附加关注点亚量表；中等颅内肿瘤体积与较少的附加关注点相关。在个体水平上，在 GKRS 后 9 个月内，大多数患者的身体状况恶化，而情绪状况改善。然而，在患者水平上，大多数患者在不同的 HRQoL 方面都有下降和改善。
我们的结果表明，即使在多达 10 个 BM 的患者中，在组和个体亚量表水平上，HRQoL 的各个方面在 GKRS 后 9 个月内仍然保持稳定，除了情绪健康的改善和身体状况的恶化。然而，HRQoL 评分在个体患者水平上差异很大。
ClinicalTrials.gov 标识符：NCT02953756，2016 年 11 月 3 日。
