Randomized data assessing the longitudinal quality of life (QoL) impact of SABR in the oligometastatic setting are lacking.
We enrolled patients who had a controlled primary malignancy with 1-5 metastatic lesions, with good performance status and life expectancy >6 months.
We randomized in a 1:2 ratio between standard of care (SOC) treatment [SOC Arm] vs. SOC plus SABR to all metastatic lesions [SABR Arm]. QoL was measured using the Functional Assessment of Cancer Therapy – General (FACT-G). QoL changes over time and between groups was assessed with linear mixed modeling.
Ninety-nine patients were randomized. Median age was 68 (range: 43-89) and 60% were male. The most common primary tumor types were breast (n=18), lung (n=18), colorectal (n=18) and prostate (n=16). Most patients (n=92) had 1-3 metastases. Median follow-up was 26 months. Because of the previously-reported inferior survival of the SOC arm, the time for attrition in QOL respondents to <10% of subjects was shorter in the SOC vs SABR arm (30 vs. 42 months). In the whole cohort, QoL declined over time after randomization: there were significant declines in total FACT-G score over time compared to baseline (p<0.001), due to declines in physical and functional subscales (both p<0.001), with no declines in social and emotional subscales. However, the magnitudes of decline were small, and CMCs were not seen at most time points. Comparison between arms showed no differences in QoL between the SABR and SOC arms in total score (p=0.42), or in the physical (p=0.98), functional (p=0.59), emotional (p=0.82) or social (p=0.17) subscales.
For patients with oligometastases, average QoL declines slowly over time regardless of treatment approach, although the changes are small in magnitude. The use of SABR, compared to SOC, was not associated with a QoL detriment.
International journal of radiation oncology, biology, physics. 2019 Aug 27 [Epub ahead of print]
Robert Olson, Suresh Senan, Stephen Harrow, Stewart Gaede, Alexander Louie, Cornelis Haasbeek, Liam Mulroy, Michael Lock, George Rodrigues, Brian Yaremko, Devin Schellenberg, Belal Ahmad, Gwendolyn Griffioen, Sashendra Senthi, Anand Swaminath, Neil Kopek, Mitchell Liu, Karen Moore, Suzanne Currie, Glenn Bauman, Andrew Warner, David Palma
BC Cancer – Centre for the North, Prince George, British Columbia, Canada. Electronic address: ., VU University Medical Center, Amsterdam, Netherlands., Beatson West of Scotland Cancer Centre, Glasgow, Scotland., London Health Sciences Centre, London, Ontario, Canada., Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada., Nova Scotia Cancer Centre, Halifax, Nova Scotia, Canada., BC Cancer – Surrey, Surrey, British Columbia, Canada., Alfred Hospital, Melbourne, Australia., Juravinski Cancer Centre, Hamilton, Ontario, Canada., McGill University Health Centre, Montreal, QC, Canada., BC Cancer – Vancouver, Vancouver, British Columbia, Canada.