Introduction:Radiotherapy (RT) is a frequently offered treatment option for brain metastases (BMs) in patients with non-small-cell lung cancer (NSCLC). This study presents patient-reported outcomes (PROs) in a cohort of NSCLC with BMs treated with RT. This study researched how PRO scores at the start of RT may be useful in survival estimates and how PROs change over time after RT.Methods:NSCLC patients with first-time BMs treated with RT were identified in a prospective observational study. PROs were collected at the start of RT and monthly for up to 1 year. Differences in PRO mean scores at the start of RT (M0) and at month 2 (M2) after treatment are reported. Prognostic values of PROs were analyzed in a stepwise adjusted Cox model.Results:Of 294 patients identified, 239 (81%) responded at M0; 105/239 (44%) responded at both M0 and M2. High scores for weakness of legs at M0 were associated with short survival when adjusting for performance status and status of extracranial metastases. Those responding at M0 only had worse mean scores for overall QoL and PF but similar scores for fatigue and dyspnea compared to patients responding over time. At M2, patients with <6 months survival after RT reported worse scores for overall QoL, PF, fatigue, and dyspnea; long-term survivors reported stable scores.Conclusions:NSCLC patients diagnosed with BMs and expected survival < 6 months should be offered optimal palliative care rather than RT.
引言：放射治疗（RT）是非小细胞肺癌（NSCLC）脑转移（BMs）患者的常用治疗选择。本研究呈现了一组接受RT治疗的NSCLC伴BMs患者的患者报告结局（PROs）。本研究探讨了RT开始时的PRO评分如何有助于生存期评估，以及RT后PROs随时间的变化情况。 方法：在一项前瞻性观察研究中，确定了首次出现BMs并接受RT治疗的NSCLC患者。在RT开始时及之后每月收集PROs，持续长达1年。报告了RT开始时（M0）和治疗后第2个月（M2）PRO平均评分的差异。通过逐步调整的Cox模型分析了PROs的预后价值。 结果：在确定的294例患者中，239例（81%）在M0时提供了反馈；其中105/239例（44%）在M0和M2时均提供了反馈。在调整体能状态和颅外转移状态后，M0时腿部无力评分高与生存期短相关。仅M0时反馈的患者与随时间持续反馈的患者相比，总体生活质量和躯体功能平均评分较差，但疲劳和呼吸困难评分相似。在M2时，RT后生存期<6个月的患者在总体生活质量、躯体功能、疲劳和呼吸困难方面报告了更差的评分；长期生存者报告了稳定的评分。 结论：对于诊断为BMs且预期生存期<6个月的NSCLC患者，应提供最佳姑息治疗而非RT。
肿瘤(癌症)患者之家