Quality of Life After Stereotactic Radiosurgery for Brain Metastases
Overview
This study analyzed real-world data from a national prospective registry to evaluate quality of life (QOL) outcomes following stereotactic radiosurgery (SRS) in patients with brain metastases. Using patient-reported EQ-5D scores, the study assessed changes in QOL alongside tumor control metrics across multiple cancer types.
Background
Brain metastases are the most common intracranial tumors in adults, frequently originating from lung, breast, melanoma, and renal cancers. These patients face significant neurological and psychological burdens impacting their quality of life. Stereotactic radiosurgery (SRS) offers precise, minimally invasive treatment that improves local tumor control and preserves cognitive function compared to whole-brain radiotherapy. Understanding QOL outcomes after SRS is critical for informed treatment decisions.
Data Highlights
The NeuroPoint Alliance SRS Registry prospectively collected data from over 5500 patients and 8400 treatment events across 27 centers. Eligible patients had brain metastases from lung cancer, breast cancer, or melanoma with pre- and post-SRS EQ-5D quality of life assessments. Baseline data included demographics, comorbidities, Karnofsky Performance Status, lesion characteristics, and treatment details. Outcomes measured included all-cause mortality, local and out-of-field progression, and overall intracranial progression. EQ-5D utility index scores ranged from 0 (death) to 1 (full health) and were assessed at baseline, 6–12 months, and last follow-up.
Key Findings
SRS effectively controls local brain metastases with defined volumetric criteria for progression.
Patients generally maintain or improve their EQ-5D quality of life scores following SRS treatment.
EQ-5D domains assessed included mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Regression analyses identified predictors of QOL outcomes at final follow-up, incorporating clinical and treatment variables.
Data imputation methods ensured robustness despite missing baseline information.
Clinical Implications
Clinicians can use these findings to counsel patients on the expected quality of life trajectory following SRS for brain metastases. The preservation or improvement of QOL domains supports SRS as a favorable treatment option compared to more invasive or diffuse therapies. Incorporating patient-reported outcomes like EQ-5D into routine care enhances shared decision-making.
Conclusion
Prospective registry data demonstrate that stereotactic radiosurgery for brain metastases preserves or improves patient-reported quality of life while achieving effective tumor control. These insights support the integration of QOL metrics in treatment planning and patient counseling.
References
NeuroPoint Alliance SRS Registry Data 2017-2023 -- Evaluating Quality of Life Following Stereotactic Radiosurgery for Brain Metastases
