Abstract
We evaluated the feasibility, reliability, and validity of the Brain Metastases Symptom Checklist (bmsc), a novel self-report measure of common symptoms experienced by patients with brain metastases. Patients with first-presentation symptomatic brain metastases (n = 137) referred for whole-brain radiotherapy (wbrt) completed the bmsc at time points before and after treatment. Their caregivers (n = 48) provided proxy ratings twice on the day of consultation to assess reliability, and at week 4 after wbrt to assess responsiveness to change. Correlations with 4 other validated assessment tools were evaluated. The symptoms reported on the bmsc were largely mild to moderate, with tiredness (71%) and difficulties with balance (61%) reported most commonly at baseline. Test-retest reliability for individual symptoms had a median intraclass correlation of 0.59 (range: 0.23-0.85). Caregiver proxy and patient responses had a median intraclass correlation of 0.52. Correlation of absolute scores on the bmsc and other symptom assessment tools was low, but consistency in the direction of symptom change was observed. At week 4, change in symptoms was variable, with improvements in weight gain and sleep of 42% and 41% respectively, and worsening of tiredness and drowsiness of 62% and 59% respectively. The bmsc captures a wide range of symptoms experienced by patients with brain metastases, and it is sensitive to change. It demonstrated adequate test-retest reliability and face validity in terms of its responsiveness to change. Future research is needed to determine whether modifications to the bmsc itself or correlation with more symptom-specific measures will enhance validity.
Highlights
Brain metastases are a common complication in many malignancies, causing significant morbidity and directly contributing to cancer mortality[1]
The symptoms reported on the bmsc were largely mild to moderate, with tiredness (71%) and difficulties with balance (61%) reported most commonly at baseline
The bmsc captures a wide range of symptoms experienced by patients with brain metastases, and it is sensitive to change
Summary
Brain metastases are a common complication in many malignancies, causing significant morbidity and directly contributing to cancer mortality[1]. They cause localized symptoms related to the location of tumour involvement and generalized symptoms from raised intracranial pressure. Many individuals with brain metastases have advanced disease, and survival remains extremely limited 2,3. Focal weakness is the presenting complaint in approximately 20% –40% of patients, and seizures are the first sign of brain metastasis in approximately 10%–20%4. A 2003 review of the literature on the natural history of brain metastases found that headache (39%), motor weakness (33%), ataxia (31%), altered mental status (31%), and dysphasia (15%) were the main presenting symptoms[5]. Princess Margaret Cancer Centre, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario M5G 2M9
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
