Abstract
Objective: We evaluated the effects of palliative radiotherapy for cancer recurrence or metastasis on patient QOL and psychophysiology. Materials and Methods: Sixty seven patients who received palliative radiotherapy between 2014 and 2015 were enrolled. Patient diseases were bone metastasis in 51 patients, lymph node metastasis in 7 patients, brain metastasis in 2 patients, local recurrence in 3 patients, and others in 4 patients. Median irradiated dose was 30 Gy in 10 fractions for palliative radiotherapy. We used the questionnaires EORTC-QLQ-C30 and EORTC-QLQ-C15-PAL to evaluate patient QOL and the Hospital Anxiety and Depression Scale to evaluate patient mental healthcare at the start and at the end of radiotherapy. Results: As compared to scores at the start of radiotherapy, at the end of radiotherapy, NRS and face scale significantly decreased. On the other hand, Eastern Cooperative Oncology Group Performance Status did not show any changes during palliative radiotherapy. In functional scales, average scores of RF2 and EF also improved. In symptom scales, average scores of FA, PA, and SL improved. In bone metastasis group, global health status/QOL, PA, and SL significantly improved. There was relationship between anxiety improvement and QOL improvement after palliative radiotherapy. Nausea and vomiting scores of EORTC-QLQ-C15-PAL were associated with the irradiated volume of palliative radiotherapy for pelvic region. Conclusion: Patient QOL of was improved by palliative radiotherapy regardless of PS. The possibility of palliative radiotherapy having a positive influence on patient psychophysiology was also suggested in younger age.
Highlights
Pain in cancer patients does not solely refer to physical pain, but various factors comprising the quality of life (QOL) are complexly involved
We evaluated the effects of palliative radiotherapy for cancer recurrence or metastasis on patient QOL and psychophysiology
We examined changes in the QOL after palliative radiotherapy for recurrent or metastatic tumors, which had not been clarified in Japan, using international QOL scales (EORTC QLQ-C30 and European Organization for Research and Treatment Cancer (EORTC) QLQ-C15-PAL), and indicated that improvements in the “pain”, “insomnia”, “emotional function”, and “fatigue” scores were achieved
Summary
Pain in cancer patients does not solely refer to physical pain, but various factors comprising the quality of life (QOL) are complexly involved. Recent studies emphasized the importance of pain relief or QOL improvement. As the purpose of palliative therapy for recurrent or metastatic tumors, pain relief or QOL improvement is more important than survival prolongation or an improvement in local control. The level of evidence regarding palliative radiotherapy for painful bone metastasis is high, and the pain improvement rating is reportedly 60% to 90% [1] [2]. Qualitative evaluation methods, such as the Numerical Rating Scale (NRS) and Face Scale, are commonly used as subjective outcome-evaluating methods. These methods facilitate simple investigation of the degree of pain, and are routinely selected. No study has evaluated patients treated by palliative radiotherapy using an adequate, international QOL scale. No study has compared/discussed the field/volume of irradiation from the viewpoint of the adverse effects of palliative radiotherapy
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