Hello, my name is Yutaro Koide. Thank you for the opportunity to introduce our new article titled "Quality of Life Report Associated With Pain Response and Patient Classification System for Palliative Radiation Therapy. First, we want to explain our previous report about the classification system. Previously, we found that high dose opioids and reirradiation were detected as predictors of a lower response rate and treated regions were categorized into Class 1, Class 2 and Class 3 with respective response rates of 75%, 61% and 36%. Our classification system will differentiate pain response, but there is still a question of whether the system also helps predict changes in patients' quality of life. Using our prospective cohort data, this quality of life study aimed to quantify the quality of life changes associated with pain response and the classification system. QoL questionnaires were used at pre-specified timing, which was the same as the pain response assessment. The primary endpoint of this study was global health status improvement at 12 weeks, based on minimally clinically important differences compared by the pain response and by class. The patient cohort was the same as a previous study of the classification system, including 366 lesions from 261 patients. Lesions with NRS 2 or higher enrolled intracranial or postoperative lesions were excluded. The data included 75% of bone metastasis, 72% using opioids, 22% received reirradiation and 93% were treated with standard dose palliative radiation. The compliance of the QoL assessment was high. At baseline, the compliance rate was 97%. 12 weeks later, the rate was 67%. A higher compliance rate was found in pain responders and Class 1 populations, compared to the other groups. Our primary endpoint of the DHS improvement rate was defined by class, which was 33% in Class 1, 31% in Class 2, and 20% in Class 3. This figure shows the proportion of improved, stable and deteriorated regions. In addition to the GHS subscale, most other subscales' improvement rates were the lowest in Class 3. This figure also shows the QoL non-evaluable regions divided with or without pain response. 28% of Class 3 regions were QoL non-evaluable regions with pain nonresponse, which was significantly greater than other classes. In conclusion, this study quantifies and compares QoL changes based on pain response and patient classification using data from the previously reported prospective observational study on palliative radiation therapy. The QoL changes associated with pain response and the classification system were identified, suggesting that the classification system may help identify populations more or less likely to improve QoL in addition to differentiating pain response rates. Thank you.
