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Title: Quality of Life After Palliative Radiation Therapy for Patients With Painful Bone Metastases: Results of an International Study Validating the EORTC QLQ-BM22

Abstract

Purpose: Radiation therapy (RT) is an effective method of palliating painful bone metastases and can improve function and reduce analgesic requirements. In advanced cancer patients, quality of life (QOL) is the primary outcome of interest over traditional endpoints such as survival. The purpose of our study was to compare bone metastasis-specific QOL scores among patients who responded differently to palliative RT. Methods and Materials: Patients receiving RT for bone metastases across 6 countries were prospectively enrolled from March 2010-January 2011 in a trial validating the QLQ-BM22 and completed the QLQ-BM22 and the core measure (QLQ-C30) at baseline and after 1 month. Pain scores and analgesic intake were recorded, and response to RT was determined according to the latest published guidelines. The Kruskal-Wallis nonparametric and Wilcoxon rank sum tests compared changes in QOL among response groups. A Bonferroni-adjusted P<.003 indicated statistical significance. Results: Of 79 patients who received palliative RT, 59 were assessable. Partial response, pain progression, and indeterminate response were observed in 22, 8, and 29 patients, respectively; there were no patients with a complete response. Patients across all groups had similar baseline QOL scores apart from physical functioning (patients who progressed had better initial functioning). One month after RT,more » patients who responded had significant improvements in 3 of 4 QLQ-BM22 domains (painful site, P<.0001; painful characteristic, P<.0001; and functional interference, P<.0001) and 3 QLQ-C30 domains (physical functioning, P=.0006; role functioning, P=.0026; and pain, P<.0001). Patients with progression in pain had significantly worse functional interference (P=.0007) and pain (P=.0019). Conclusions: Patients who report pain relief after palliative RT also have better QOL with respect to bone metastasis-specific issues. The QLQ-BM22 and QLQ-C30 are able to discriminate among patients with varying responses and are recommended for use in future bone metastasis clinical trials.« less

Authors:
 [1];  [1]; ;  [1];  [2];  [3];  [4];  [5];  [6];  [7];  [8];  [9];  [10];  [11];  [12]
  1. Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto, Ontario (Canada)
  2. Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada)
  3. Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia (Cyprus)
  4. Department of Clinical Oncology, Tanta University Hospital, Tanta Faculty of Medicine, Tanta (Egypt)
  5. Department of Orthopedic Oncology, Federal University of Sao Paulo, Sao Paulo (Brazil)
  6. Division of Gynaecology and Genitourinary Oncology, Department of Radiation Oncology, Regional Cancer Center, Trivandrum (India)
  7. Inserm CIE3, Saint Etienne University Hospital, Saint-Etienne (France)
  8. (France)
  9. Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan (China)
  10. Department of Gastroenterologic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (China)
  11. Department of Public Health and Institute of Epidemiology and Preventative Medicine, National Taiwan University, Taipei, Taiwan (China)
  12. European Organisation for Research and Treatment of Cancer, EORTC Headquarters, Brussels (Belgium)
Publication Date:
OSTI Identifier:
22149588
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANALGESICS; CLINICAL TRIALS; METASTASES; NEOPLASMS; PAIN; PATIENTS; RADIOTHERAPY; RECOMMENDATIONS; SKELETON; STANDARD OF LIVING

Citation Formats

Zeng Liang, Chow, Edward, E-mail: edward.chow@sunnybrook.ca, Bedard, Gillian, Zhang, Liying, Fairchild, Alysa, Vassiliou, Vassilios, Alm El-Din, Mohamed A., Jesus-Garcia, Reynaldo, Kumar, Aswin, Forges, Fabien, Unit of Clinical Research, Innovation, and Pharmacology, Saint Etienne University Hospital, Saint-Etienne, Tseng, Ling-Ming, Hou, Ming-Feng, Chie, Wei-Chu, and Bottomley, Andrew. Quality of Life After Palliative Radiation Therapy for Patients With Painful Bone Metastases: Results of an International Study Validating the EORTC QLQ-BM22. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.05.028.
Zeng Liang, Chow, Edward, E-mail: edward.chow@sunnybrook.ca, Bedard, Gillian, Zhang, Liying, Fairchild, Alysa, Vassiliou, Vassilios, Alm El-Din, Mohamed A., Jesus-Garcia, Reynaldo, Kumar, Aswin, Forges, Fabien, Unit of Clinical Research, Innovation, and Pharmacology, Saint Etienne University Hospital, Saint-Etienne, Tseng, Ling-Ming, Hou, Ming-Feng, Chie, Wei-Chu, & Bottomley, Andrew. Quality of Life After Palliative Radiation Therapy for Patients With Painful Bone Metastases: Results of an International Study Validating the EORTC QLQ-BM22. United States. doi:10.1016/J.IJROBP.2012.05.028.
Zeng Liang, Chow, Edward, E-mail: edward.chow@sunnybrook.ca, Bedard, Gillian, Zhang, Liying, Fairchild, Alysa, Vassiliou, Vassilios, Alm El-Din, Mohamed A., Jesus-Garcia, Reynaldo, Kumar, Aswin, Forges, Fabien, Unit of Clinical Research, Innovation, and Pharmacology, Saint Etienne University Hospital, Saint-Etienne, Tseng, Ling-Ming, Hou, Ming-Feng, Chie, Wei-Chu, and Bottomley, Andrew. Thu . "Quality of Life After Palliative Radiation Therapy for Patients With Painful Bone Metastases: Results of an International Study Validating the EORTC QLQ-BM22". United States. doi:10.1016/J.IJROBP.2012.05.028.
@article{osti_22149588,
title = {Quality of Life After Palliative Radiation Therapy for Patients With Painful Bone Metastases: Results of an International Study Validating the EORTC QLQ-BM22},
author = {Zeng Liang and Chow, Edward, E-mail: edward.chow@sunnybrook.ca and Bedard, Gillian and Zhang, Liying and Fairchild, Alysa and Vassiliou, Vassilios and Alm El-Din, Mohamed A. and Jesus-Garcia, Reynaldo and Kumar, Aswin and Forges, Fabien and Unit of Clinical Research, Innovation, and Pharmacology, Saint Etienne University Hospital, Saint-Etienne and Tseng, Ling-Ming and Hou, Ming-Feng and Chie, Wei-Chu and Bottomley, Andrew},
abstractNote = {Purpose: Radiation therapy (RT) is an effective method of palliating painful bone metastases and can improve function and reduce analgesic requirements. In advanced cancer patients, quality of life (QOL) is the primary outcome of interest over traditional endpoints such as survival. The purpose of our study was to compare bone metastasis-specific QOL scores among patients who responded differently to palliative RT. Methods and Materials: Patients receiving RT for bone metastases across 6 countries were prospectively enrolled from March 2010-January 2011 in a trial validating the QLQ-BM22 and completed the QLQ-BM22 and the core measure (QLQ-C30) at baseline and after 1 month. Pain scores and analgesic intake were recorded, and response to RT was determined according to the latest published guidelines. The Kruskal-Wallis nonparametric and Wilcoxon rank sum tests compared changes in QOL among response groups. A Bonferroni-adjusted P<.003 indicated statistical significance. Results: Of 79 patients who received palliative RT, 59 were assessable. Partial response, pain progression, and indeterminate response were observed in 22, 8, and 29 patients, respectively; there were no patients with a complete response. Patients across all groups had similar baseline QOL scores apart from physical functioning (patients who progressed had better initial functioning). One month after RT, patients who responded had significant improvements in 3 of 4 QLQ-BM22 domains (painful site, P<.0001; painful characteristic, P<.0001; and functional interference, P<.0001) and 3 QLQ-C30 domains (physical functioning, P=.0006; role functioning, P=.0026; and pain, P<.0001). Patients with progression in pain had significantly worse functional interference (P=.0007) and pain (P=.0019). Conclusions: Patients who report pain relief after palliative RT also have better QOL with respect to bone metastasis-specific issues. The QLQ-BM22 and QLQ-C30 are able to discriminate among patients with varying responses and are recommended for use in future bone metastasis clinical trials.},
doi = {10.1016/J.IJROBP.2012.05.028},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}