Rehabilitation in primary and metastatic brain tumours
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- Tang, V., Rathbone, M., Park Dorsay, J. et al. J Neurol (2008) 255: 820. doi:10.1007/s00415-008-0695-z
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Patientswith brain tumours have majordisabilities and guarded prognosisbut may benefit from inpatient rehabilitation.The objectives were tocompare functional outcomes inpatients with glioblastoma multiforme(GBM), brain metastasesand other brain tumours, and todetermine predictors of survival.
Demographic, clinical,functional, and survival data werecollected for 63 patients.Kaplan-Meier and Cox regression wereused for survival analyses.
Functional Independence Measure(FIM™) scores improved fromadmission to discharge for patientswith GBM, brain metastases andother tumours. Estimated mediansurvival was 141 days for brainmetastases, 214 days for GBM and439 days for other tumours. Lowadmission dexamethasone doseand high FIM™ gain predictedbetter survival in GBM. For brainmetastases, high FIM™ gain, lowdexamethasone dose and no organmetastases were positive prognosticfactors.
Patientswith primary and metastatic braintumours achieved functional gainsafter rehabilitation. High functionalimprovement is a significantpredictor of longer survival inbrain metastases and GBM. Thisstudy has implications for rehabilitationin the post-acute managementof patients who have disabilitiesdue to brain tumours.