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Application of the
Edmonton Functional Assessment Tool (EFAT) in patients with brain metastases
(BM) treated only with palliative radiotherapy (PRT)
S. Kahl, R. A. Sala, L. Mengelle, M. Alarcón, L. E. Fein
T.R. Cumbres and Pergamino Radiotherapy Institute, Rosario,
Argentina; Hospital Escuela Eva Peron, Granadero Baigorria, Argentina; T.R.
Cumbres S.A Radiotherapy Institute, Rosario, Argentina; Centro Estadístico,
Rosario, Argentina; Centro Oncológico de Rosario, Rosario, Argentina
Background. The EFAT is a validated tool to asses the functional status
of cancer patients in palliative care, like Karnofsky index (KPS) and
neurological function class (NFC) scales.
BM are a frequent complication of cancer.
Despite PRT plus corticoids mean overall survival does not exceed 6
months.
At present, the evaluation of PRT impact in terms other than survival are
scarce.
To evaluate the impact of PRT in patients with BM, we applied EFAT and their
results were compared with KPS and NFC (all performed before and after
treatment).
Methods. Between January 1997 and December 2002, 71 (of 122) patients
with BM were treated only with PRT and corticoids.
Wilcoxon, t-Student, χ² or Fisher tests were used as needed;
P<0.01 was considered of statistical significance.
Results. 37 women and 34 men (60.3 ± 1.3 years ± SE).
Mean survival was 6.5 ± 0.6 months.
KPS did not showed significant changes after PRT; however, NFC did
(P=0.001).
Mean EFAT score had a statistically significant improvement with PRT in patients
with BM only (group 1), (P< 0.0001); but in patients with metastases in and
outside CNS (group 2) (Table I) the score did not showed significance.
Conclusions. Both EFAT and NFC showed statistical significance as a
measure of positive impact of PRT in group 1.
Moreover, EFAT best identified specific areas of benefit in both groups of
patients probably allowing further treatment strategies.
If proper symptom control could improve statistical significance in group 2
remains to be established.
Table I. EFAT score of patients with BM and out of SNC
metastases.
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In-CNS
(group 1. n=31)
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In and Out-CNS
(group 2. n=40)
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Total patients
(n=71)
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Communication
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P=0.0008
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P=0.002
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P<0.0001
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Mental Alert
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P=0.002
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P=0.01
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P=0.0001
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Pain
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NS
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NS
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NS
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Respiratory Function
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NS
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NS
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NS
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Balance
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P=0.0005
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P=0.009
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P<0.0001
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Motility
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P=0.0002
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P=0.007
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P<0.0001
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Mobility
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P=0.004
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P=0.0008
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P<0.0001
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Activity level
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NS
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NS
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NS
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Motivation
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NS
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NS
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P=0.01
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Activities daily living
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NS
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P=0.007
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P=0.001
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TOTAL SCORE
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P<0.001
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NS
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P<0.0001
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Copyright 2004 American Society of Clinical Oncology All rights
reserved worldwide.
Source: http://www.asco.org/ac/1,1003,_12-002636-00_18-0026-00_19-002636,00.asp
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