Bone metastases are a common event for cancer patients. We have developed an innovative and unique clinical research program dedicated to palliative radiation oncology at the Odette Cancer Centre, Sunnybrook Health Sciences Centre and specifically a multidisciplinary clinic for bone metastases. The development of this program introduces an effective strategy to conduct research in palliative radiation oncology. Symptom control is very important for the quality of life for bone and brain metastases patients. This is an evolving active field of research as greater emphasis is being placed into understanding the goals of improving not only a patient’s survival, but the ability for therapies to improve the quality of a patient's life. In this book we present the EORTC QLQ-C30 questionnaire, which was used in a multi-center study with patients recruited from Edmonton, Alberta, Canada; Kaohsiung, Taiwan; Kerala, India; Nicosia, Cyprus; Sao Paulo, Brazil; Taipei, Taiwan; Tanta, Egypt; and Toronto, Ontario, Canada, with brain and bone metastases. It was found that the difficulties bone and brain metastases patients experience are different in several ways. Patients with bone metastases have more pain and reduced physical functioning. However, patients with brain metastases have more severe role functioning deficits. With use of the QLQ-C30, it was also found that there is ambiguity regarding the root of patient issues. Future studies that require more comprehensive disease-specific findings should include disease-specific assessment modules such as the QLQ-BM22 and QLQ-BN20. Important domains such as the minimal clinically important difference should also be established in individual subgroups of patients to assist in clinical trial design.
Table of Contents
Introduction; A Unique Case of Long-bone Disease Responding to Radiotherapy Alone; Painful Sacral Insufficiency Fracture Simulating Metastatic Disease from Primary Breast Cancer; Pathological Fracture of the Tibia in a Patient with Invasive Ductal Carcinoma of the Breast: A Case Report of a Rare Finding; Renal Mass – Primary or Metastatic? The Search for a Definitive Diagnosis; Suspicious Perianal Lesion in a Patient with Renal Cell Carcinoma; Osteonecrosis of the Jaw Appearing as Bone Metastases in a Bone Scan in a Patient with Breast Cancer; Unusual Presentation of Osteolytic Bone Metastases in Prostate Adenocarcinoma; Asymptomatic Presentation of Lung & Bone Metastases in a Patient with Breast Cancer; Prophylaxis with Radiation Treatment after Surgery to the Cervical Spine for Established Heterotopic Ossification; Good Surgical Outcome & Long Survival in a Patient with Occipitocervical Instability Requiring Occiput to C3 Fixation; Pain Relief through Palliative Radiation Therapy in a Patient with Cervical Spine Bone Metastases; Single Fraction Palliative Radiation Treatment in the Treatment of Bone Metastases with Soft Tissue Mass; Radiation Therapy Alone for Established Heterotopic Ossification; Focal Myositis as a Presentation of Paraneoplastic Syndrome in Pancreatic Cancer; Heterotopic Ossification: Mimics of Other Benign & Malignant Etiologies; Quality of Life Measures Used in Radiation Therapy Trials for Patients with Metastatic Spinal Cord Compression (MSCC); The Palliative Performance Scale: Examining its Correlation to the Karnofsky Performance Scale in an Outpatient Palliative Radiation Oncology Clinic; Confirmatory Factor Analysis of Brief Pain Inventory (BPI) Functional Interference Clusters in Patients with Bone Metastases; Correlation of the Palliative Performance Scale with the Karnofsky Performance Status in an Outpatient Palliative Radiotherapy Clinic; Comparison of Baseline Quality of Life Scores in Patients with Bone & Brain Metastases as Assessed using the EORTC QLQ-C30; Comparison of Baseline Quality of Life Scores in Patients with Bone & Brain Metastases as Assessed using the EORTC QLQ-C15-PAL; Review of Brain Metastases Research in the Rapid Response Radiotherapy Program (RRRP); Review of Symptom Cluster Research in the Rapid Response Radiotherapy Program (RRRP); Symptom Clusters in Metastatic Cancer: A Critical Appraisal; Symptom Clusters in Patients with Prostate Cancer: A Literature Review; Dedicated Out-Patient Palliative Radiation Treatment Clinics for Patients with Advanced Cancer; Needs Assessment of Patients & their Caregivers; Determining the Accuracy of Health Care Professionals in Predicting the Survival of Patients with ; Rapid Response Radiotherapy Program & Multidisciplinary Bone Metastases Clinic; Barriers to Prescription of Sublingual Fentanyl Tablets for Breakthrough Cancer Pain in an Out-Patient Cancer Center; Review of Radiation-Induced Nausea & Vomiting Research in the Rapid Response Radiotherapy Program; Radiation-Induced Nausea & Vomiting in a Palliative Radiotherapy Clinic; Evaluation of a Daily Diary for Assessing the Prevalence of Radiation Induced Emesis (RIE); Review of Bone Metastases Research in the Rapid Response Radiotherapy Program (RRRP); Conventional Radiation Treatment & Bone Metastases; Palliative Radiotherapy of Bone Metastases & Pain Flare; Bone Metastases & Quality of Life; Positron Emission Tomography & Bone Metastases; A Review of the Impact of Oxygen Therapy in Patients with Advanced Lung Disease; Long-Term Survival in Patients with Brain Metastases from Non Small Cell Lung Carcinoma; Palliative Radiotherapy in the Treatment of Lung Metastases or Advanced Lung Cancer; Index.