Skip to main content
Top
Published in: Journal of Neuro-Oncology 3/2019

Open Access 01-07-2019 | Metastasis | Clinical Study

Health-related quality of life of patients with brain metastases selected for stereotactic radiosurgery

Authors: Eline Verhaak, Karin Gehring, Patrick E. J. Hanssens, Margriet M. Sitskoorn

Published in: Journal of Neuro-Oncology | Issue 3/2019

Login to get access

Abstract

Purpose

Information on health-related quality of life (HRQoL) of patients with brain metastases (BM) before stereotactic radiosurgery (SRS) is very relevant to improve communication between patients and clinicians and to be able to interpret changes in HRQoL after SRS. The aim of this study was to evaluate the prevalence and severity of complaints on different aspects of pre-SRS HRQoL among patients with BM and to identify predictors thereof.

Methods

Patients with 1–10 newly diagnosed BM, expected survival > 3 months, Karnofsky Performance Status ≥ 70, and scheduled to undergo SRS were included. HRQoL was measured with the Functional Assessment of Cancer Therapy-Brain (FACT-Br) questionnaire. One-sample z-tests were conducted to analyze differences between patients with BM and published normative data of a general adult sample and of an adult cancer sample. Multiple regression analyses were run to identify predictors of pre-SRS HRQoL.

Results

On the individual level, most patients with BM (57.6% of 92 included patients) reported complaints regarding emotional well-being. As a group, patients with BM reported significantly lower emotional well-being compared to both control groups and significantly higher social well-being compared to the general population. Worse psychological factors, e.g. physical fatigue, depression, mental fatigue and anxiety, predicted aspects of pre-SRS HRQoL.

Conclusions

An increased understanding of pre-SRS HRQoL and predictors hereof, provides us with more insight into the well-being of our patients with BM and is necessary for the interpretation of (changes in) HRQoL after SRS.
Appendix
Available only for authorised users
Literature
1.
go back to reference Kaal EC, Niël CG, Vecht CJ (2005) Therapeutic management of brain metastasis. Lancet Neurol 4(5):289–298PubMed Kaal EC, Niël CG, Vecht CJ (2005) Therapeutic management of brain metastasis. Lancet Neurol 4(5):289–298PubMed
2.
go back to reference Lassman AB, DeAngelis LM (2003) Brain metastases. Neurol Clin 21(1):1–23PubMed Lassman AB, DeAngelis LM (2003) Brain metastases. Neurol Clin 21(1):1–23PubMed
3.
go back to reference Brown PD, Jaeckle K, Ballman KV, Farace E, Cerhan JH, Anderson SK et al (2016) Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: a randomized clinical trial. JAMA 316(4):401–409PubMedPubMedCentral Brown PD, Jaeckle K, Ballman KV, Farace E, Cerhan JH, Anderson SK et al (2016) Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: a randomized clinical trial. JAMA 316(4):401–409PubMedPubMedCentral
4.
go back to reference Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG et al (2009) Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol 10(11):1037–1044PubMed Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG et al (2009) Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol 10(11):1037–1044PubMed
5.
go back to reference Zeng KL, Raman S, Sahgal A, Soliman H, Tsao M, Wendzicki C et al (2017) Patient preference for stereotactic radiosurgery plus or minus whole brain radiotherapy for the treatment of brain metastases. Ann Palliat Med 6(2):S155–S160PubMed Zeng KL, Raman S, Sahgal A, Soliman H, Tsao M, Wendzicki C et al (2017) Patient preference for stereotactic radiosurgery plus or minus whole brain radiotherapy for the treatment of brain metastases. Ann Palliat Med 6(2):S155–S160PubMed
6.
go back to reference Elaimy AL, Mackay AR, Lamoreaux WT, Fairbanks RK, Demakas JJ, Cooke BS et al (2011) Clinical outcomes of stereotactic radiosurgery in the treatment of patients with metastatic brain tumors. World Neurosurg 75(5):673–683PubMed Elaimy AL, Mackay AR, Lamoreaux WT, Fairbanks RK, Demakas JJ, Cooke BS et al (2011) Clinical outcomes of stereotactic radiosurgery in the treatment of patients with metastatic brain tumors. World Neurosurg 75(5):673–683PubMed
7.
8.
go back to reference Habets EJ, Dirven L, Wiggenraad RG, Verbeek-de Kanter A, Lycklama à Nijeholt GJ, Zwinkels H et al (2016) Neurocognitive functioning and health-related quality of life in patients treated with stereotactic radiotherapy for brain metastases: a prospective study. Neuro-oncology 18(3):435–444PubMed Habets EJ, Dirven L, Wiggenraad RG, Verbeek-de Kanter A, Lycklama à Nijeholt GJ, Zwinkels H et al (2016) Neurocognitive functioning and health-related quality of life in patients treated with stereotactic radiotherapy for brain metastases: a prospective study. Neuro-oncology 18(3):435–444PubMed
9.
go back to reference van der Meer PB, Habets EJ, Wiggenraad RG, Verbeek-de Kanter A, à Nijeholt GJL, Zwinkels H et al (2018) Individual changes in neurocognitive functioning and health-related quality of life in patients with brain oligometastases treated with stereotactic radiotherapy. J Neurooncol 139(2):359–368PubMedPubMedCentral van der Meer PB, Habets EJ, Wiggenraad RG, Verbeek-de Kanter A, à Nijeholt GJL, Zwinkels H et al (2018) Individual changes in neurocognitive functioning and health-related quality of life in patients with brain oligometastases treated with stereotactic radiotherapy. J Neurooncol 139(2):359–368PubMedPubMedCentral
10.
go back to reference Bragstad S, Flatebø M, Natvig GK, Eide GE, Skeie GO, Behbahani M et al (2017) Predictors of quality of life and survival following Gamma Knife surgery for lung cancer brain metastases: a prospective study. J Neurosurg 129(1):71–83PubMed Bragstad S, Flatebø M, Natvig GK, Eide GE, Skeie GO, Behbahani M et al (2017) Predictors of quality of life and survival following Gamma Knife surgery for lung cancer brain metastases: a prospective study. J Neurosurg 129(1):71–83PubMed
11.
go back to reference Skeie BS, Eide GE, Flatebø M, Heggdal JI, Larsen E, Bragstad S et al (2017) Quality of life is maintained using Gamma Knife radiosurgery: a prospective study of a brain metastases patient cohort. J Neurosurg 126(3):708–725PubMed Skeie BS, Eide GE, Flatebø M, Heggdal JI, Larsen E, Bragstad S et al (2017) Quality of life is maintained using Gamma Knife radiosurgery: a prospective study of a brain metastases patient cohort. J Neurosurg 126(3):708–725PubMed
13.
go back to reference Thavarajah N, Bedard G, Zhang L, Cella D, Beaumont JL, Tsao M et al (2014) Psychometric validation of the functional assessment of cancer therapy—brain (FACT-Br) for assessing quality of life in patients with brain metastases. Support Care Cancer 22(4):1017–1028PubMed Thavarajah N, Bedard G, Zhang L, Cella D, Beaumont JL, Tsao M et al (2014) Psychometric validation of the functional assessment of cancer therapy—brain (FACT-Br) for assessing quality of life in patients with brain metastases. Support Care Cancer 22(4):1017–1028PubMed
14.
go back to reference Weitzner MA, Meyers CA, Gelke CK, Byrne KS, Levin VA, Cella DF (1995) The functional assessment of cancer therapy (FACT) scale. Development of a brain subscale and revalidation of the general version (FACT-G) in patients with primary brain tumors. Cancer 75(5):1151–1161PubMed Weitzner MA, Meyers CA, Gelke CK, Byrne KS, Levin VA, Cella DF (1995) The functional assessment of cancer therapy (FACT) scale. Development of a brain subscale and revalidation of the general version (FACT-G) in patients with primary brain tumors. Cancer 75(5):1151–1161PubMed
15.
go back to reference Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579PubMed Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579PubMed
16.
go back to reference Brucker PS, Yost K, Cashy J, Webster K, Cella D (2005) General population and cancer patient norms for the Functional Assessment of Cancer Therapy-General (FACT-G). Eval Health Prof 28(2):192–211PubMed Brucker PS, Yost K, Cashy J, Webster K, Cella D (2005) General population and cancer patient norms for the Functional Assessment of Cancer Therapy-General (FACT-G). Eval Health Prof 28(2):192–211PubMed
17.
go back to reference Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370PubMed Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370PubMed
18.
go back to reference Smets E, Garssen B, Bonke BD, De Haes J (1995) The multidimensional fatigue inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res 39(3):315–325PubMed Smets E, Garssen B, Bonke BD, De Haes J (1995) The multidimensional fatigue inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res 39(3):315–325PubMed
19.
go back to reference Benedict RH, Schretlen D, Groninger L, Brandt J (1998) Hopkins verbal learning test–revised: normative data and analysis of inter-form and test-retest reliability. Clin Neuropsychol 12(1):43–55 Benedict RH, Schretlen D, Groninger L, Brandt J (1998) Hopkins verbal learning test–revised: normative data and analysis of inter-form and test-retest reliability. Clin Neuropsychol 12(1):43–55
20.
go back to reference Tombaugh TN (2004) Trail making test A and B: normative data stratified by age and education. Arch Clin Neuropsychol 19(2):203–214PubMed Tombaugh TN (2004) Trail making test A and B: normative data stratified by age and education. Arch Clin Neuropsychol 19(2):203–214PubMed
21.
go back to reference Bryden P, Roy E (2005) A new method of administering the Grooved Pegboard Test: performance as a function of handedness and sex. Brain Cogn 58(3):258–268PubMed Bryden P, Roy E (2005) A new method of administering the Grooved Pegboard Test: performance as a function of handedness and sex. Brain Cogn 58(3):258–268PubMed
22.
go back to reference Chang EL, Wefel JS, Maor MH, Hassenbusch SJ III, Mahajan A, Lang FF et al (2007) A pilot study of neurocognitive function in patients with one to three new brain metastases initially treated with stereotactic radiosurgery alone. Neurosurgery 60(2):277–284PubMed Chang EL, Wefel JS, Maor MH, Hassenbusch SJ III, Mahajan A, Lang FF et al (2007) A pilot study of neurocognitive function in patients with one to three new brain metastases initially treated with stereotactic radiosurgery alone. Neurosurgery 60(2):277–284PubMed
24.
go back to reference Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Earlbaum Associates, Hillsdale, NJ Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Earlbaum Associates, Hillsdale, NJ
25.
go back to reference Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc B 57:289–300 Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc B 57:289–300
26.
go back to reference Lin NU, Wefel JS, Lee EQ, Schiff D, van den Bent MJ, Soffietti R et al (2013) Challenges relating to solid tumour brain metastases in clinical trials, part 2: neurocognitive, neurological, and quality-of-life outcomes. A report from the RANO group. Lancet Oncol 14(10):e407–e416PubMed Lin NU, Wefel JS, Lee EQ, Schiff D, van den Bent MJ, Soffietti R et al (2013) Challenges relating to solid tumour brain metastases in clinical trials, part 2: neurocognitive, neurological, and quality-of-life outcomes. A report from the RANO group. Lancet Oncol 14(10):e407–e416PubMed
27.
go back to reference Pham A, Lo SS, Sahgal A, Chang EL (2016) Neurocognition and quality-of-life in brain metastasis patients who have been irradiated focally or comprehensively. Expert Rev Qual Life Cancer Care 1(1):45–60 Pham A, Lo SS, Sahgal A, Chang EL (2016) Neurocognition and quality-of-life in brain metastasis patients who have been irradiated focally or comprehensively. Expert Rev Qual Life Cancer Care 1(1):45–60
28.
go back to reference Gehring K, Taphoorn MJ, Sitskoorn MM, Aaronson NK (2015) Predictors of subjective versus objective cognitive functioning in patients with stable grades II and III glioma. Neuro-oncol Pract 2(1):20–31 Gehring K, Taphoorn MJ, Sitskoorn MM, Aaronson NK (2015) Predictors of subjective versus objective cognitive functioning in patients with stable grades II and III glioma. Neuro-oncol Pract 2(1):20–31
29.
go back to reference Jacobsen PB, Davis K, Cella D (2002) Assessing quality of life in research and clinical practice. Oncology 16(9 Suppl 10):133–140PubMed Jacobsen PB, Davis K, Cella D (2002) Assessing quality of life in research and clinical practice. Oncology 16(9 Suppl 10):133–140PubMed
30.
go back to reference Jacobsen PB, Jim HS (2008) Psychosocial interventions for anxiety and depression in adult cancer patients: achievements and challenges. CA: Cancer J Clin 58(4):214–230 Jacobsen PB, Jim HS (2008) Psychosocial interventions for anxiety and depression in adult cancer patients: achievements and challenges. CA: Cancer J Clin 58(4):214–230
31.
go back to reference Osborn RL, Demoncada AC, Feuerstein M (2006) Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med 36(1):13–34PubMed Osborn RL, Demoncada AC, Feuerstein M (2006) Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med 36(1):13–34PubMed
32.
go back to reference Breitbart W, Rosenfeld B, Pessin H, Applebaum A, Kulikowski J, Lichtenthal WG (2015) Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer. J Clin Oncol 33(7):749PubMedPubMedCentral Breitbart W, Rosenfeld B, Pessin H, Applebaum A, Kulikowski J, Lichtenthal WG (2015) Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer. J Clin Oncol 33(7):749PubMedPubMedCentral
33.
go back to reference Spinhoven P, Ormel J, Sloekers P, Kempen G, Speckens A, Van Hemert A (1997) A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 27(2):363–370PubMed Spinhoven P, Ormel J, Sloekers P, Kempen G, Speckens A, Van Hemert A (1997) A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 27(2):363–370PubMed
34.
go back to reference Smets E, Garssen B, Cull A, De Haes J (1996) Application of the multidimensional fatigue inventory (MFI-20) in cancer patients receiving radiotherapy. Br J Cancer 73(2):241PubMedPubMedCentral Smets E, Garssen B, Cull A, De Haes J (1996) Application of the multidimensional fatigue inventory (MFI-20) in cancer patients receiving radiotherapy. Br J Cancer 73(2):241PubMedPubMedCentral
35.
go back to reference Verhage F (1964) Intelligentie en leeftijd: onderzoek bij Nederlanders van twaalf tot zevenenzeventig jaar. Van Gorcum, Assen Verhage F (1964) Intelligentie en leeftijd: onderzoek bij Nederlanders van twaalf tot zevenenzeventig jaar. Van Gorcum, Assen
Metadata
Title
Health-related quality of life of patients with brain metastases selected for stereotactic radiosurgery
Authors
Eline Verhaak
Karin Gehring
Patrick E. J. Hanssens
Margriet M. Sitskoorn
Publication date
01-07-2019
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 3/2019
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-019-03186-z

Other articles of this Issue 3/2019

Journal of Neuro-Oncology 3/2019 Go to the issue