Health Related Quality of Life Outcomes Following Stereotactic Body Radiotherapy in Patients with Oligo-Metastatic Disease: An Individual Patient Data Meta-Analysis

Abstract

<h3>Purpose/Objective(s)</h3> Health-related quality of life (HRQOL) outcomes are lacking in patients with oligo-metastatic disease (OMD) receiving stereotactic body radiotherapy (SBRT). The aim of this individual patient data meta-analysis was to determine the effect of SBRT on the HRQOL of patients with OMD. <h3>Materials/Methods</h3> As part of a previously described systematic review (PROSPERO 2021 CRD42021238506), the primary outcome of this individual patient data meta-analysis was change in HRQOL at 12-months from baseline in patients with OMD who received SBRT (versus not), reported as standardized mean difference (SMD). Random effects models implemented in RevMan (Cochrane Collaboration) were used for meta-analyses of scores. <h3>Results</h3> Of 7556 publications identified, four studies met inclusion criteria (2 single arm interventional studies and 2 randomized controlled trials [RCTs]). Individual patient data were available from three studies (175 patients). In the two RCTs, there was no statistically significant difference in the SMD between patients who received SBRT and those that did not (0.09 [95% CI -0.32, 0.5], P=0.66). On meta-analysis of patients (N=107) who received SBRT, SMD was -0.23 (95% CI [-0.42, -0.04] versus -0.25 (95% CI [-0.57, 0.07]) in those who did not (N=37) receive SBRT, demonstrating a small deterioration from baseline. For all patients (SBRT and SOC) measured by the Global Health/Quality of Life (GHQOL) EORTC QLQ-C30 (N=80), a small deterioration was found in both the GHQOL change score from baseline to 12-months (-0.27, 95% CI -0.49, -0.05) and in those who received SBRT alone (N=57) (-0.27, 95% CI -0.52, -0.02). <h3>Conclusion</h3> In patients with OMD, there is no difference in HRQOL at 12-months from baseline between patients who received SBRT and those that did not. However, a small HRQOL deterioration was found in both groups of patients. More robust assessment and reporting of HRQOL in studies of OMD is needed to better inform patient decision-making.