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Abstract：
BACKGROUND: Brain metastases (BM) are a common complication in advanced cancer patients, and extremely challenging to treat. Consequently, whole brain radiotherapy (WBRT) remains the standard palliative intervention for patients with BM. The present study set to evaluate the clinical benefits of WBRT by assessing the quality of life (QoL) in WBRT-treated patients with BM, in Nigeria.
METHODS: This was a prospective, longitudinal, hospital-based single-centre study. Consecutive sampling methodology was used to recruit 52 patients with BM undergoing WBRT. Patients were followed up on days 7, 30, 90 and 180 after WBRT. The EORTC QLQ-C15-PAL and EORTC QLQ-BN20 were employed to report patients\' responses. The likert scale responses were linearly converted into 0 - 100 scores, and the descriptive analysis was conducted using IBM SPSS Statistics 29.0, at 95% confidence interval, using the two-tailed t-test for continuous variables or the chi-square test for categorical values. The overall survival was calculated with the Kaplan Maier method and the difference tested with Log-rank method, considering the interval from the baseline until death or end of the study.
RESULTS: The study cohort was predominantly females (82.7%), and accordingly, 65.4% of the respondents had a breast primary tumor. A goodness-of-fit test yielded non-significant Chi square Pearson (p = 0.325) and Deviance (p = 1.000) residuals, indicating the best fit. The median overall survival was 180 days (~ 6 months). A total of 20 patients (38%) that survived up to 180 days reported alleviated symptoms and better functioning. A significant improvement in physical functioning (p < 0.001) and emotional functioning (p = 0.031) was reported at 180 days post WBRT, compared to baseline.
CONCLUSIONS: WBRT is an effective palliative intervention in patients with BM, resulting in improved QoL. More than 50% of patients that survived ~ 3 months reported alleviation of pain, and 38% of patients that survived for ~ 6 months reported a significantly improved functioning. This demonstrated the clinical benefits of WBRT in palliative care and will add to the body of data on the use of WBRT, from Africa.
METHODS: This was a prospective, longitudinal, hospital-based single-centre study. Consecutive sampling methodology was used to recruit 52 patients with BM undergoing WBRT. Patients were followed up on days 7, 30, 90 and 180 after WBRT. The EORTC QLQ-C15-PAL and EORTC QLQ-BN20 were employed to report patients\' responses. The likert scale responses were linearly converted into 0 - 100 scores, and the descriptive analysis was conducted using IBM SPSS Statistics 29.0, at 95% confidence interval, using the two-tailed t-test for continuous variables or the chi-square test for categorical values. The overall survival was calculated with the Kaplan Maier method and the difference tested with Log-rank method, considering the interval from the baseline until death or end of the study.
RESULTS: The study cohort was predominantly females (82.7%), and accordingly, 65.4% of the respondents had a breast primary tumor. A goodness-of-fit test yielded non-significant Chi square Pearson (p = 0.325) and Deviance (p = 1.000) residuals, indicating the best fit. The median overall survival was 180 days (~ 6 months). A total of 20 patients (38%) that survived up to 180 days reported alleviated symptoms and better functioning. A significant improvement in physical functioning (p < 0.001) and emotional functioning (p = 0.031) was reported at 180 days post WBRT, compared to baseline.
CONCLUSIONS: WBRT is an effective palliative intervention in patients with BM, resulting in improved QoL. More than 50% of patients that survived ~ 3 months reported alleviation of pain, and 38% of patients that survived for ~ 6 months reported a significantly improved functioning. This demonstrated the clinical benefits of WBRT in palliative care and will add to the body of data on the use of WBRT, from Africa.
摘要：
背景：脑转移（BM）是晚期癌症患者的常见并发症，治疗极具挑战性。因此,全脑放疗（WBRT）仍然是BM患者的标准姑息性干预措施。本研究旨在通过评估WBRT治疗的BM患者的生活质量（QoL）来评估WBRT的临床益处，在尼日利亚。
方法：这是一个前瞻性的，纵向,以医院为基础的单中心研究。采用连续抽样方法招募52例接受WBRT的BM患者。在WBRT后第7、30、90和180天随访患者。EORTCQLQ-C15-PAL和EORTCQLQ-BN20用于报告患者的反应。利克特量表的反应被线性转换为0-100分，描述性分析使用IBMSPSSStatistics29.0进行，置信区间为95%，连续变量采用双尾t检验，分类值采用卡方检验。用KaplanMaier方法计算总生存期，用Log-rank方法检验差异，考虑从基线到死亡或研究结束的间隔。
结果：研究队列主要是女性（82.7%），因此，65.4%的受访者患有乳腺原发性肿瘤。拟合优度检验得出非显著卡方皮尔森(p=0.325)和偏差(p=1.000)残差，表明最适合。中位总生存期为180天(~6个月)。存活180天的总共20名患者（38％）报告症状缓解和功能更好。在WBRT后180天，身体功能（p<0.001）和情绪功能（p=0.031）显着改善。与基线相比。
结论：WBRT是BM患者的有效姑息性干预措施，从而改善QoL。存活约3个月的患者中，超过50%的患者报告疼痛减轻，存活约6个月的患者中有38%报告功能显著改善。这证明了WBRT在姑息治疗中的临床益处，并将增加WBRT使用的数据，来自非洲。
方法：这是一个前瞻性的，纵向,以医院为基础的单中心研究。采用连续抽样方法招募52例接受WBRT的BM患者。在WBRT后第7、30、90和180天随访患者。EORTCQLQ-C15-PAL和EORTCQLQ-BN20用于报告患者的反应。利克特量表的反应被线性转换为0-100分，描述性分析使用IBMSPSSStatistics29.0进行，置信区间为95%，连续变量采用双尾t检验，分类值采用卡方检验。用KaplanMaier方法计算总生存期，用Log-rank方法检验差异，考虑从基线到死亡或研究结束的间隔。
结果：研究队列主要是女性（82.7%），因此，65.4%的受访者患有乳腺原发性肿瘤。拟合优度检验得出非显著卡方皮尔森(p=0.325)和偏差(p=1.000)残差，表明最适合。中位总生存期为180天(~6个月)。存活180天的总共20名患者（38％）报告症状缓解和功能更好。在WBRT后180天，身体功能（p<0.001）和情绪功能（p=0.031）显着改善。与基线相比。
结论：WBRT是BM患者的有效姑息性干预措施，从而改善QoL。存活约3个月的患者中，超过50%的患者报告疼痛减轻，存活约6个月的患者中有38%报告功能显著改善。这证明了WBRT在姑息治疗中的临床益处，并将增加WBRT使用的数据，来自非洲。
