Quality of life in patients with brain metastases using the EORTC QLQ-BN20 and QLQ-C30

Abstract

Given the poor life expectancy of the majority of patients with brain metastases, quality of life (QOL) endpoints are especially valuable to assess in this population. The present study assessed QOL in patients with brain metastases before and after treatment for their disease. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the EORTC Brain Cancer Module (EORTC QLQ-BN20) questionnaire were administered to assess the QOL of patients with brain metastases before and 1 month after treatment. Linear regression analysis was applied to assess changes in QOL scores over time and to examine associations between the QLQ-BN20 and QLQ-C30 scales, patient demographics and clinical variables. Associations between the QLQ-BN20 and QLQ-C30 scales were evaluated using Spearman correlation. There were 47 patients assessed at baseline, 31 (67%) completed follow-up at 1 month post-treatment. The majority (81%) of patients received whole-brain radiotherapy only. Future uncertainty (QLQ-BN20) and fatigue (QLQ-C30) were the most prominent symptoms at baseline. Most QLQ-BN20 and QLQ-C30 scales did not significantly change from baseline to follow-up with the exception of hair loss (p = 0.0004) and itchy skin (p < 0.0001), which worsened post-treatment. Baseline KPS was positively correlated with QLQ-C30 physical functioning scale but negatively correlated to QLQ-BN20 motor dysfunction (p = 0.016), hair loss (p = 0.013) and leg weakness (p = 0.015) as well as QLQ-C30 pain (p = 0.042) and appetite loss (p = 0.030). The maintenance of nearly all QOL scores 1 month after treatment indicates the treatment intervention likely played a symptom-stabilizing role and prevented QOL deterioration in the palliative setting.