Symptom response after palliative radiotherapy for patients with brain metastases

Bezjak, Andrea; Adam, Janice; Barton, Rachael; Panzarella, Tony; Laperrière, Normand; Wong, Christine; Mason, Warren P.; Buckley, C.A.; Levin, Wilfred; McLean, Michael; Wu, Jianrong; Sia, Michael; Kirkbride, Peter

doi:10.1016/s0959-8049(01)00150-2

Cited by 123 publications

(140 citation statements)

References 21 publications

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“…Another study investigated the survival and QOL of patients who were randomized to WBRT with efaproxiral or to WBRT alone 70 . Six other studies examined the role of QOL or patient-rated symptoms when assessing the effectiveness of WBRT 17,[71][72][73][74][75] . Two studies assessed the neurocognitive function (NCF) of patients who had been treated with WBRT and a radiosensitizer 76 or with WBRT alone 27 .…”

Section: Multiple Brain Metastasesmentioning

confidence: 99%

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Quality of Life in Brain Metastases Radiation Trials: A Literature Review

et al. 2008

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BackgroundAn estimated 20%-40% of cancer patients will develop brain metastases. Whole-brain radiotherapy (WBRT) is the standard treatment for patients with brain metastases. Although WBRT can reduce neurologic symptoms, the median survival following WBRT is between 3 and 6 months. Given this limited survival, it is important to consider quality of life (QOL) when treating patients with brain metastases. However, few studies have focused on QOL and improvement in patient-rated symptoms as primary outcomes. ObjectiveFor an accurate measurement of the extent to which previous trials have utilized QOL tools to evaluate the efficacy of WBRT for treatment of brain metastases, we undertook a literature review to examine the common endpoints and QOL instruments used. MethodsWe conducted a systematic search using the MEDLINE (1950( to December 2007 and Cochrane Central Register of Controlled Trials (4th quarter 2007) databases. Eligible studies investigated WBRT in one of the study arms. The following outcomes were included: median survival, overall survival, neurologic function, 1-year local control, and overall response; use of QOL instruments, performance status scales, and neurologic function assessments; and use of other assessment tools. Patient-rated QOL instruments were defined as those that strove to assess all dimensions of QOL; observerrated performance instruments such as the Karnofsky performance status (KPS) were deemed to be performance scales. ResultsWe identified sixty-one trials that included WBRT nine evaluated the treatment of a single brain metastasis, and fifty-two evaluated the treatment of multiple brain metastases. Although fifty-five of the trials employed a QOL instrument, few trials focused on QOL as an outcome. We found 23 different instruments used to evaluate QOL. The most commonly employed instrument was the KPS (n = 33), followed by various neurologic function classification scales (n = 21). A preponderance of the studies used 1 (n = 26, 43%) or 2 (n = 21, 34%) QOL instruments.A total of fourteen published trials on brain metastases included an evaluation of the study population's QOL. Those trials included three that used the Functional Assessment of Cancer Therapy-General scale and Brain subscale instrument, three that used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (C30) and the Brain Cancer Module 20 instrument, two that used study-designed QOL instruments, one that used the Edmonton Symptom Assessment Scale, two that used the Spitzer Quality of Life index, and three that used the KPS to evaluate QOL. Some trials reported deterioration in QOL after WBRT in patients with poorer prognosis; other trials detected an improvement in QOL after WBRT in patients with better prognosis. ConclusionsTo date, fourteen trials in brain metastases that have included an evaluation of the study population's QOL have been published. Although some studies showed that certain parameters of QOL deteriorate after WBRT, other studies showed that Q...

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Section: Multiple Brain Metastasesmentioning

confidence: 99%

“…Neurologic function classification 21 Order classification 1 Study-designed neurologic instrument 71 1 …”

Section: Instrument Frequencymentioning

confidence: 99%

Quality of Life in Brain Metastases Radiation Trials: A Literature Review

et al. 2008

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“…For multiple brain metastases, whole brain irradiation and stereotactic radiosurgery are the only therapeutic measures currently available (21)(22)(23)(24)(25). Whole brain radiotherapy (WBRT) is usually delivered in 10 fractions of 3 Gy (total dose: 30 Gy; ref.…”

Section: Introductionmentioning

confidence: 99%

“…Higher doses are detrimental to normal brain tissues, causing mental and psychomotor dysfunctions. Unfortunately, WBRT with 30 Gy is insufficient to improve overall survival in patients with multiple brain metastases; however, it has been shown to prolong the symptom-free intervals and may relief some of the symptoms (21). Stereotactic radiosurgery processes, such as "gamma knife" have been shown to be safe and effective for upfront and salvage treatments in patients with 5 or more brain metastases (25).…”

Section: Introductionmentioning

confidence: 99%

Radretumab Radioimmunotherapy in Patients with Brain Metastasis: A 124I-L19SIP Dosimetric PET Study

Poli

Bianchi

Virotta

et al. 2013

Cancer Immunology Research

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Radioimmunotherapy (RIT) with 131 I-labeled L19SIP (radretumab; a small immunoprotein format antibody directed against the ED-B domain of fibronectin; $80 kDa molecular weight) has been investigated in several clinical trials. Here, we describe the use of immuno-PET imaging with iodine-124 ( 124 I)-labeled L19SIP to predict doses delivered to tumor lesions and healthy organs by a subsequent radretumab RIT in patients with brain metastases from solid cancer. Bone marrow doses were evaluated both during the diagnostic phase and posttherapy, measuring activities in blood (germanium detector) and whole body (lanthanum bromide detector). Expected doses for radretumab administration (4,107 MBq/m 2 ) were calculated from data obtained after administration of an average of 167 MBq 124 I-L19SIP to 6 patients. To assess lesion average doses, the positron emission tomography (PET) scanner was calibrated for the use of 124 I with an International Electrotechnical Commission (IEC) Body Phantom and recovery coefficients were calculated. The average dose to bone red marrow was 0.21 Gy/GBq, with high correlation between provisional and actual posttherapy doses. Although the fraction of injected activity in normal organs was similar in different patients, the antibody uptake in the neoplastic lesions varied by as much as a factor of 60. Immuno-PET with 124 I-labeled L19SIP offers significant advantages over conventional 131 I imaging, in particular accuracy of dosimetric results. Furthermore, the study indicates that antibody uptake can be highly variable even in different lesions of the same patient and that immuno-PET procedures may guide product development with armed antibodies. Cancer Immunol Res; 1(2); 134-43. Ó2013 AACR.

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“…However, the role of radiotherapy remains controversial. 7 Even though this treatment modality has been shown effective for local tumor control, survival benefits have been modest, ranging from 3 to 5 months. [4][5][6] More so, WBRT has been associated with significant side effects.…”

mentioning

confidence: 99%

Enhanced chemotherapy delivery by intraarterial infusion and blood‐brain barrier disruption in the treatment of cerebral metastasis

Fortin

Gendron

Boudrias

et al. 2007

Cancer

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Cationic polyurethane‐fluorinated acrylate hybrid dispersions (PUFA) were prepared by the copolymerization of styrene, butyl acrylate, and 2,2,3,4,4,4‐hexafluorobutyl methacrylate in the medium of crosslinked polyurethane via phase inversion polymerization. The said polyurethane was synthesized in acetone from 2,4‐tolyene diisocyanate, N‐methyldiethanolamine, trimethylolpropane, and soft polyester diol block. The influences of hydrophilic monomer on the surface properties, immersion behaviors, particle size and, zeta potential of the dispersions were investigated. The results show that the addition of hydrophilic monomer can be advantaged to the stability of dispersions and yet will increase the surface free energy by more than 19.9%. The PUFA coating films cured at ambient conditions have the lower surface free energy (less than 0.02033 J/m2). At the same time, there is an obvious mobility of fluorinated groups in fluorinated polymer films. © 2005 Wiley Periodicals, Inc. J Appl Polym Sci, 2006

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Symptom response after palliative radiotherapy for patients with brain metastases

Cited by 123 publications

References 21 publications

Quality of Life in Brain Metastases Radiation Trials: A Literature Review

Quality of Life in Brain Metastases Radiation Trials: A Literature Review

Radretumab Radioimmunotherapy in Patients with Brain Metastasis: A 124I-L19SIP Dosimetric PET Study

Enhanced chemotherapy delivery by intraarterial infusion and blood‐brain barrier disruption in the treatment of cerebral metastasis

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