Quality of life changes after stereotactic ablative radiotherapy for liver metastases: A prospective cohort analysis. Issue 3 (December 2018)

• Record Type: Journal Article
• Authors: Helou, Joelle; Thibault, Isabelle; Chu, William; Munoz-Schuffenegger, Pablo; Erler, Darby; Rodrigues, George; Warner, Andrew; Chan, Kelvin K.W.; Chow, Edward; Korol, Renee; Davidson, Melanie; Chung, Hans T.
• Is Part Of: Radiotherapy and oncology. Volume 129:Issue 3(2018)
• Page Start: 435
• Page End: 440
• Publication Date: 2018-12
• Subjects: Stereotactic ablative radiotherapy -- Liver metastases -- Quality of life -- Patient-reported outcomes; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2018.09.011
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: The acute effects on quality of life of liver SBRT for patients are minimal. In our cohort, liver SBRT led to transient worsening of fatigue, appetite and nausea. By 12 weeks post-SBRT, most patients have recovered to their baseline quality of life. Unirradiated liver volume less than 800 mL was associated with worse quality of life. Abstract: Purpose: To report the changes in quality of life (QoL) after stereotactic ablative radiotherapy (SABR) in patients with liver metastases (LM). Materials and methods: A prospective cohort study was undertaken to measure the acute changes in QoL after SABR. Patients with 1–3 treated LM were eligible. Doses of 30–60 Gy in 3–5 fractions were delivered. Prospective QoL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires, Core 15 for Palliative Care (EORTC QLQ-C15-PAL) and liver metastases (LM21), at baseline, 1st week and last day of treatment, then 1, 6 and 12 weeks after SABR. The functional living index-emesis (FLIE) was collected at baseline, 1st week, last day and 1 week after treatment. Univariable and multivariable linear mixed modeling were performed as appropriate to assess changes in QoL over time. Results: Sixty patients were included. The most common primary cancer was colorectal (42%). The global health score measured by QLQ-C15-PAL was significantly worse at treatment completion ( p = 0.001), 1 week ( p = 0.003) and 6 weeks ( p = 0.002) after SABR but recovered by 12 weeks ( p = 0.124). Nausea and constipation were worse at treatment completion ( p < 0.05) but recovered 1 week after while fatigue recovered 6 weeks post-SABR. The majority of patients reported stable QoL at 12 weeks for all domains in the C15-PAL and LM21 questionnaires. Conclusion: SABR offers a non-invasive mean of ablating LM with minimal impact on acute QoL.