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Prospective Study of Quality of Life in Adults with Newly Diagnosed High-grade Gliomas

  • Clinical Study
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Summary

Objective

To assess baseline quality of life (QOL) and its prognostic importance for adults with newly diagnosed high-grade gliomas, we analyzed QOL and outcome data prospectively collected in three phase II high-grade glioma protocols.

Methods

At study entry, patients completed five self-administered forms to assess overall QOL (linear analogue scale assessment [LASA] and Functional Assessment of Cancer Therapy-Brain [FACT-Br]); fatigue (Symptom Distress Scale [SDS]); excessive daytime somnolence (Epworth Sleepiness Scale [ESS]); and depression (POMS-SF). Folstein Mini-Mental State Examination (MMSE) and Eastern Cooperative Oncology Group (ECOG) performance scores (PS) were obtained by the health care provider.

Results

Baseline QOL data were available for 194 of 220 patients (88%) enrolled in the three protocols. Differences in baseline QOL among the three studies were not statistically significant. One-third of patients had clinically significant fatigue at baseline. Increased fatigue (P  = 0.003), excessive daytime somnolence (P  = 0.01), and lower overall QOL scores (LASA, P  = 0.001; FACT-Br, P  = 0.0001) correlated with worse ECOG PS. No relation was found between QOL and corticosteroid or anticonvulsant therapy, extent of resection, tumor grade, or sex. Multivariate analyses found worse ECOG PS (PS 2, P  = 0.007) associated with increased fatigue. Worse ECOG PS (PS 2, P  = 0.002) was also associated with worse overall QOL (LASA). On multivariate analyses of survival, increased fatigue (P  = 0.003) predicted poorer overall survival.

Conclusions

Performance status is related to QOL in patients with newly diagnosed high-grade brain tumors. Increased fatigue is an independent predictor of overall survival. Interventional studies directed at improving QOL, especially fatigue, may have important benefits for these patients.

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Abbreviations

CART:

classification and regression tree

ECOG:

Eastern Cooperative Oncology Group

ESS:

Epworth Sleepiness Scale

FACT-Br:

Functional Assessment of Cancer Therapy-Brain

GTR:

Gross Total Resection

KPS:

Karnofsky performance scale

LASA:

linear analogue scale assessment

MMSE:

Folstein Mini-Mental State Examination

NCCTG:

North Central Cancer Treatment Group

POMS-SF:

Profiles of Mood States Short Form

PS:

performance scores

QOL:

quality of life

SD:

standard deviation

SDS:

Symptom Distress Scale

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Authors and Affiliations

  1. Division of Radiation Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, United States Minor Outlying Islands

    Paul D. Brown

  2. Division of Biostatistics, Mayo Clinic, Rochester, Minnesota

    Karla V. Ballman, Matthew J. Maurer & Jeff A. Sloan

  3. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota

    Teresa A. Rummans, Lalit Gupta & Matthew M. Clark

  4. Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota

    Jan C. Buckner

  5. Department of Neurology, Mayo Clinic, Rochester, Minnesota

    Bradley F. Boeve

  6. Department of Neurology, Mayo Clinic, Jacksonville, Florida

    David F. Tang-Wai

  7. Roger Maris Cancer Center, Fargo, North Dakota

    Robert M. Arusell

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  1. Paul D. Brown
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Correspondence to Paul D. Brown.

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Brown, P.D., Ballman, K.V., Rummans, T.A. et al. Prospective Study of Quality of Life in Adults with Newly Diagnosed High-grade Gliomas. J Neurooncol 76, 283–291 (2006). https://doi.org/10.1007/s11060-005-7020-9

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