Neurocognitive and quality of life measures in patients with metastatic brain disease

The assessment of neurocognitive function and quality of life (QOL) in patients with brain metastases has become increasingly recognized as an important addition to traditional outcome measures such as length of survival and time to disease progression. Although objective assessment of neurocognitive function using standardized neuropsychological tests is well established, QOL represents a more subjective concept for which no gold standard assessment tool has been identified. Assessment of both neurocognitive function and QOL should involve reliable and valid measures that are sensitive to the cognitive domains and aspects of patient well-being that are most affected by brain metastases and associated treatments. Thorough evaluation of these factors is critical to understanding baseline (ie, pretreatment) cognitive functioning and QOL, monitoring the effects of necessary treatments and allowing comparison of available treatments, informing future treatment decisions, and facilitating the development and implementation of tailored behavioral and pharmacologic interventions that minimize the effect of symptoms on functional well-being.