Assessment of Health-related Quality of Life with the European Organization for Research and Treatment of Cancer QLQ-C15-PAL after Palliative Radiotherapy of Bone Metastases

Aims: To assess health-related quality of life (HRQOL) after palliative radiotherapy for painful bone metastases using a palliative questionnaire (European Organization for Research and Treatment of Cancer QLQ-C15-PAL). Materials and methods: Patients scheduled to receive palliative radiotherapy for painful bone metastases (n = 178) completed the QLQ-C15-PAL questionnaire before treatment and at week 1, week 2, month 1 and month 2 after the first day of radiotherapy. A partial response (PR) or a complete response (CR) to radiotherapy was defined according to the International Consensus criteria. General linear regression was used to analyse changes in QOL in the entire cohort and within responders and non-responders to radiotherapy at all follow-up periods. Results: The overall radiotherapy response was 45% at week 1 (n = 21) (41% PR, 4% CR), 62% at week 2 (n = 28) (58% PR, 4% CR), 62% at month 1 (n = 58) (60% PR, 2% CR) and 65% at month 2 (n = 38) (60% PR, 5% CR). In general, a significant decrease in pain (P < 0.0001), insomnia (P < 0.0001) and constipation (P=0.004) was seen by month 1 after radiotherapy. In patients who responded to radiotherapy, overall QOL significantly improved by month 2 after radiotherapy (P=0.002). Radiotherapy responders also reported an improvement in emotional functioning together with a decrease in symptoms such as insomnia and constipation at month 1. No improvements were seen in any of the QLQ-C15-PAL scores for patients whose pain did not respond to radiotherapy. Conclusion: Radiotherapy responders showed not only an improvement in pain, but also in HRQOL as assessed by QLQ-C15-PAL. As early as 1 week after radiotherapy for bone metastases, a pain relief response was reported by patients. (C) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.