Topline
Methodology
- Uncertainty persists about the value of palliative radiation, particularly longer regimens, among patients with high-grade gliomas.
- To address the uncertainty, investigators administered quality of life (QoL) questionnaires to patients before receiving 35 Gy of palliative radiation in 10 fractions over 2 weeks, then again 1 month after treatment, followed by every 3 months until disease progression or death.
- Overall, 49 of 55 patients (89%) completed radiation treatment, and 42 completed the surveys.
- QoL was assessed using the 100-point European Organization for Research and Treatment of Cancer QoL core questionnaire (QLQ-C30) and its brain cancer module (BN20).
- Two-thirds of patients were treated with temozolomide chemotherapy following radiation.
Takeaways
- There was clinically and statistically significant improvement 1 month after radiation therapy in patient-reported fatigue and dyspnea on the QLQ-C30.
- A clinically meaningful improvement – meaning a 10-point or greater improvement – was seen for insomnia. Other symptoms, such as nausea/vomiting, loss of appetite, constipation, diarrhea, and financial difficulty, remained stable over time.
- On the BN20, investigators reported clinically and statistically significant improvement in motor function; other symptoms remained stable.
- Median progression-free survival was 8.4 months; median overall survival was 10.5 months.
In practice
“Short-course palliative hypofractionated radiotherapy in patients with poor-prognosis [high-grade glioma] does not impair QoL in the short term; but is rather associated with stable and/or improved QoL scores in several domains/symptom scales” at 1-3 months after treatment, “making it a viable resource-sparing alternative regimen,” the authors concluded.
Source
The work, led by Y. Baviskar of the Tata Memorial Hospital department of radiation oncology in Mumbai, India, was published July 11 in Clinical Oncology.
Limitations
- It was a single-center study with no control arm.
- Fewer patients completed QoL forms over time, limiting longitudinal assessment to 3 months.
- Forms might have been completed by caregivers at times, raising questions about the veracity of responses.
Disclosures
- There was no external funding for the work.
- The investigators report no relevant financial relationships.
A version of this article appeared on Medscape.com.