NDLI: Physician expectations of treatment outcomes for patients with brain metastases referred for whole brain radiotherapy.

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Physician expectations of treatment outcomes for patients with brain metastases referred for whole brain radiotherapy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Barnes, Elizabeth A. Chow, Edward Tsao, May N. Bradley, Nicole M. Doyle, Meagan Li, Kathy Lam, Kelvin Danjoux, Cyril
Description	Country affiliation: Canada Author Affiliation: Barnes EA ( Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Toronto, ON, Canada. toni.barnes@sunnybrook.ca)
Abstract	PURPOSE: Patients with advanced cancer are referred to our Rapid Response Radiotherapy Program for quick access to palliative radiotherapy. The primary objective of this prospective study was to determine the physician expectations of the treatment outcomes for patients with brain metastases referred for whole brain radiotherapy (WBRT). The secondary objectives were to determine the factors influencing the expectations and to examine the accuracy of the physician-estimated patient survival. METHODS AND MATERIALS: Patients were identified during a 17-month period. The referring physicians were sent a survey by facsimile to be completed and returned before the patient consultation. Information was sought on the patient's disease status, the physician's expectations of WBRT, the estimated patient survival and performance status, and physician demographic data. RESULTS: A total of 137 surveys were sent out, and the overall response rate was 57.7%. The median patient age was 66 years (range, 35-87), 78.5% had multiple brain metastases, 42.3% had a controlled primary tumor, and 62.3% had extracranial disease. WBRT was thought to stabilize neurologic symptoms, improve quality of life, and allow for a Decadron (dexamethasone) taper by > or =94.9% of the referring physicians; 87.0% thought WBRT would improve performance status; 77.9% thought it would improve neurologic symptoms; and 40.8% thought it would improve survival. The referring physicians estimated patient survival as a median of 6.0 months; however, the actual survival was a median of 2.5 months, for a median individual difference of 1.9 months (p < .0001). CONCLUSION: Physicians referring patients with brain metastases for consideration of WBRT are often overly optimistic when estimating the clinical benefit of the treatment and overestimate patient survival. These findings highlight the need for education and additional research in this field.
File Format	HTM / HTML
ISSN	03603016
Issue Number	1
Volume Number	76
e-ISSN	1879355X
Journal	International Journal of Radiation OncologyastBiologyastPhysics
Language	English
Publisher	Elsevier
Publisher Date	2010-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Radiology Attitude Of Health Personnel Brain Neoplasms Radiotherapy Cranial Irradiation Methods Referral And Consultation Adult Aged Aged, 80 And Over Mortality Secondary Dexamethasone Administration & Dosage Glucocorticoids Health Status Indicators Humans Karnofsky Performance Status Life Expectancy Middle Aged Palliative Care Prospective Studies Quality Of Life Questionnaires Time Factors Treatment Outcome Journal Article
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Cancer Research Radiation Oncology

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