QOL-28. The experience of patients with lung cancer with brain metastases: neurocognitive deficits and patient-reported functional difficulties and mood

BACKGROUND Brain metastases affect over 50% of patients with advanced lung cancer, though their impact on patients’ functioning and symptoms has not been well-described. We aimed to characterize and explore associations between neurocognitive deficits, functional difficulties, and mood. METHODS This is a cross-sectional study of patient-reported outcomes among patients with lung cancer with brain metastases at the time of stereotactic radiosurgery (SRS) evaluation, using a prospectively collected single-site registry. We summarized patients’ demographic and clinical data, neurocognitive deficits per clinician exam, and patient-reported functioning (self-care, usual activities, mobility) and mood (anxiety/depression) using the European Quality of Life 5-Dimensions 3-Level Version. We used logistical regressions to assess associations between (1) the presence of neurocognitive deficits and functional difficulties and (2) the presence of functional difficulties and mood symptoms, adjusting for age, tobacco use, performance status, and extracranial disease status. RESULTS Among 463 patients, the mean age was 65.4 years at cancer diagnosis and 20.5% had controlled extracranial disease at SRS evaluation. One third (33.9%) of patients demonstrated any neurocognitive deficit, such as gait dysfunction/incoordination (14.7%), motor deficit (13.2%), sensory deficit (5.2%), memory decline (5.0%), visual deficit/double vision (3.7%), cranial nerve deficit (3.5%), or concentration decline (0.9%). Many (38.7%) self-reported any functional difficulty, including with usual activities (32.1%), mobility (28.9%), or self-care (15.8%), as well as anxiety/depression (15.3%). Motor deficits and gait dysfunction/incoordination were associated with difficulties with mobility, self-care, and usual activities (ORs=4.05-9.16, p’s<0.01). Difficulties with usual activities were associated with anxiety/depression (OR=4.81, p<0.01). CONCLUSIONS Patients with lung cancer with brain metastases experience functional difficulties, particularly if they have motor deficits or gait dysfunction/incoordination. Patients also experience mood symptoms, especially if they have difficulties with usual activities. These findings highlight the need for tailored supportive care for patients with lung cancer with brain metastases.