HOUT-13. PATIENT REPORTED OUTCOME MEASURES IN BRAIN METASTASES PATIENTS – A SYSTEMATIC REVIEW

Abstract

Brain metastases (BMs) represent an important health care problem, with increasing incidence rates over time. Due to the heterogeneity of patient and tumor characteristics, it is hard to find consensus on optimal treatment strategy. Especially in palliative care, it is important to measure treatment effects on quality of life (QOL) from the patients’ perspective. Patient reported outcome measures (PROMs) can facilitate optimal treatment choice and even improve outcome in BMs patients. The aim of this review was to systematically analyze implementation and validity of different PROMs in BMs patients. PubMed, Embase, and Cochrane databases were systematically searched for studies on PROMs in patients with BMs. Study selection, data extraction, and quality assessment were performed independently by two investigators. Quality of PRO reporting was determined using the ISOQOL-recommended PRO reporting standards and each questionnaire was assessed using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) grading criteria. In total, 53 studies were included, comprising 5358 patients with primary tumor types: lung (61%), breast (16%), gastrointestinal (4%), renal (3%), melanoma (2%), urogenital (2%), other (8%), and unknown (4%). Nine different PROMs were applied, ranging from general cancer (FACT-G, EORTC-QLQ-C15-PAL, ESAS, SF-36, McGill QOL, EuroQol-5D) to brain specific (FACT-Br, BASIQ, EORTC-QLQ-BN20) questionnaires. Half of the general cancer questionnaires (n=3) were not validated among BM patients. According to a predefined cut-off point in line with previous work, 22 studies had insufficient quality of PRO reporting. A variety of PROMs are used in BM patients, including questionnaires intended for general cancer and general patient populations, which have not been validated in patients with BMs. Given the unique clinical considerations in patients with brain metastases, our results indicate the need for a standardized and validated questionnaire with high level of reporting for BM patients.