News | January 12, 2010

Physicians Overly Optimistic about WBRT Outcomes

January 13, 2010 - Whole brain radiotherapy (WBRT) is often recommended for patients with advanced cancer to receive quick access to palliative radiotherapy.

A recent study published in the International Journal of Radiation Oncology Biology Physics found that 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.

The primary objective of the study was to determine what are physician’s expectations of treatment outcomes for patients with brain metastases referred for whole brain radiotherapy (WBRT). As a secondary objective, researchers were trying to understand what factors influence the expectations and to determine the accuracy of the physician-estimated patient survival.

Of the nearly 80 referring physicians surveyed, more than 94.9 percent said they believed WBRT would stabilize neurologic symptoms, improve quality of life, and allow for a Decadron (dexamethasone) taper; 87.0 percent said WBRT would improve performance status; 77.9 percent expected it to improve neurologic symptoms; and 40.8 percent thought it would improve survival. While the actual survival patient survival was a median of two and a half months, the referring physicians estimated patient survival rates would reach six months on average. This discrepancy represented a median individual difference of 1.9 months.

This led researchers to conclude referring physicians’ expectations of WBRT outcomes are often overly optimistic, the physicians tend to over estimate patient survival, and more education and research in this field is needed.

Reference: Barnes, EA; Chow, E; Tsao, MN; Bradley, NM; Doyle, M; Li, K; Lam, K; Danjoux, C. Physician Expectations of Treatment Outcomes for Patients With Brain Metastases Referred for Whole Brain Radiotherapy. Int J Radiat Oncol Biol Phys. 2010 Jan 1;76(1):187-192.

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