OBJECTIVES: To explore the degree of agreement between PRO, time –trade-off (TTO) utility and CROs in metastatic brain disease patients- neurocognitive function (NCF), Karnofsky performance status (KPS) and quality of life METHODS: We retrospectively analyzed secondary data from 96 brain disease patients (57  randomized and  39  non-randomized metastatic ) who completed tests to determine TTO utility with three time horizons (1, 5, and 10 years), NCF, KPS, quality of life (Functional Assessment of Cancer Therapy–Brain [FACT-BR]) and symptoms (MD Anderson Symptom Inventory–Brain Tumor [MDASI-BT]). Multiple linear regression analyses were used to explore the relationships between TTO utility and other outcome variables.  RESULTS: The CROs  significantly associated with TTO utility were the FACT-BR (p-value<0.01 for 10- and 5- year TTO utility and 0.021 for 1-year TTO utility respectively) and the MDASI-BT (sleep) scores (p-value = 0.045 and 0.034 for 10- and 5- year TTO utility respectively). However the associations found were not strong. The NCF and KPS scores were not significantly associated with TTO utility.  CONCLUSIONS: None of the functional scores used in metastatic brain disease explain patients’ decisions to trade time for better quality of life. Quality of life scores are significant predictors of TTO utility, but they have only a limited impact on  patients’ decisions. Therefore it is essential to use PROs t and incorporate patients’ perspectives of their symptoms and care and to complement the traditional CROs.