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Quality
of life (QOL) in patients (pts) with brain metastases (BM) is strongly related
to MRI tumor volume and neurocognitive function (NCF): baseline results from the
phase III trial of motexafin gadolinium (MGd)
C
Terhaard, M P Mehta, P Rodrigus, A Rao, J Suh, W Roa, L Souhami, A Bezjak, M
Leibenhaut, R Komaki, C Schultz, R Timmerman, T Illidge, C Meyers, W J Curran,
SC Phan, J Smith, MF Renschler
Academisch
Hospital, Utrecht, Netherlands; University of Wisconsin, Madison, WI; Dr.
Bernard Verbeeten Institute, Tilburg, Netherlands; Kaiser Permanente, Los
Angeles, CA; Cleveland Clinic, Cleveland, OH; Cross Cancer Inst, Edmonton, AB,
Canada; Montreal General Hospital, Montreal, QC, Canada; Princess Margaret
Hospital, Toronto, ON, Canada; Radiological Associates of Sacramento,
Sacramento, CA; M.D. Anderson Cancer Center, Houston, TX; Medical College of
Wisconsin, Milwaukee, WI; Indiana University, Indianapolis, IN; Wessex Cancer
Center, Southampton, UK; Thomas Jefferson, Philadelphia, PA; Pharmacyclics Inc,
Sunnyvale, CA
Purpose.
To determine if self-reported QOL is related to objective tumor measurements or
NCF in newly diagnosed BM pts.
Method.
In a prospective phase III trial of MGd and whole brain radiation therapy (WBRT)
vs. WBRT alone, pts with BM had NCF and QOL (FACT-BR) testing before
randomization.
A battery of NCF tests were given to assess memory, verbal fluency, executive
function, motor speed, and dexterity.
BM number and volume of up to six indicator lesions was determined by contrast
enhanced MRI.
Results.
98.1% of the 426 pts (263 lung, 81 breast cancer), with a mean (median) of 6.4
(3. 5) brain metastases completed the FACT-BR.
FACT-BR scores were correlated with BM volume (r= 0.172, p=0.0019), more than
they were with the number of brain metastases (r= -0.127, p=0.021).
The correlation with tumor volume was derived entirely from the brain related
QOL items (r=-0.226, p=0.0001), and not the remaining FACT-G items (r= -0.086,
p=0.1217).
Impairment in each NCF test was strongly associated with worse QOL on FACT-BR
(all p<0.0289), and brain related additional concerns (all p<0.0011).
The 181 (42.6%) pts who were more impaired in global NCF (4 - 7 tests impaired)
reported significantly lower QOL in FACT-BR (p=0.0001), FACT-G (p=0.0018), and
brain related additional concerns (p=0.0001), than did the 244 (57.4%) pts with
less impaired NCF (<4 tests impaired).
Conclusions.
QOL, measured with the FACT-BR in brain metastasis pts enrolled in the phase III
trial of WBRT ±MGD,
is highly related to objective tumor measurements on MRI (volume>number), and
objective, standardized neurocognitive measurements.
© Copyright 2002 American
Society of Clinical Oncology
Source:
http://www.asco.org/ac/1,1003,_12-002324-00_18-002002-00_19-00290-00_29-00A-00_42-00ONeill-00_43-00-00_44-00-00_45-00
Author-00_46-00Title-00_47-00Title-00_48-00and-00_49-00and,00.asp?cat=CNS+Tumors&parent=CENTRAL+NERVOUS+SYSTEM+TUMORS
&returnpid=2323
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