Symptom Burden in Patients With Oligometastases at the Start of Palliative Radiotherapy

Abstract

Recent studies suggested that patients with oligometastases have a better prognosis compared with those who have widespread dissemination. In both groups, radiotherapy is a commonly applied treatment. Patient-reported symptoms might depend on the burden of disease. Possibly, oligometastatic patients report lower scores for symptoms, such as fatigue or reduced appetite, which tend to worsen as the disease progresses to a later stage. Therefore, we analyzed the symptom scores in two groups of patients with or without oligometastatic disease. A retrospective study was performed in 83 patients who received palliative, non-ablative radiotherapy for distant metastases. The Edmonton Symptom Assessment Scale (ESAS) was employed to assess the pre-radiotherapy symptoms. The oligometastatic group was smaller than anticipated (n=11). The ESAS score differences were not statistically significant. However, oligometastatic patients reported less fatigue, pain and dry mouth (p<0.2). They also had a better performance status. The median survival of oligometastatic patients was longer (8.1 vs. 5.5 months, p=0.17), in the absence of ablative metastases-directed treatment. The oligometastatic state is not a major contributor to the variable patient-reported symptom scores.