Journal of Neuro-Oncology

, Volume 76, Issue 3, pp 283–291

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

  • Paul D. Brown
  • Karla V. Ballman
  • Teresa A. Rummans
  • Matthew J. Maurer
  • Jeff A. Sloan
  • Bradley F. Boeve
  • Lalit Gupta
  • David F. Tang-Wai
  • Robert M. Arusell
  • Matthew M. Clark
  • Jan C. Buckner
Clinical Study

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 ( = 0.003), excessive daytime somnolence ( = 0.01), and lower overall QOL scores (LASA, = 0.001; FACT-Br, = 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, = 0.007) associated with increased fatigue. Worse ECOG PS (PS 2, = 0.002) was also associated with worse overall QOL (LASA). On multivariate analyses of survival, increased fatigue ( = 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.

Keywords

brain glioma multivariate analysis prognosis survival 

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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Copyright information

© Springer 2005

Authors and Affiliations

  • Paul D. Brown
    • 1
  • Karla V. Ballman
    • 2
  • Teresa A. Rummans
    • 3
  • Matthew J. Maurer
    • 2
  • Jeff A. Sloan
    • 2
  • Bradley F. Boeve
    • 5
  • Lalit Gupta
    • 3
  • David F. Tang-Wai
    • 6
  • Robert M. Arusell
    • 7
  • Matthew M. Clark
    • 3
  • Jan C. Buckner
    • 4
  1. 1.Division of Radiation OncologyMayo ClinicRochesterUnited States Minor Outlying Islands
  2. 2.Division of BiostatisticsMayo ClinicRochester
  3. 3.Department of Psychiatry and PsychologyMayo ClinicRochester
  4. 4.Division of Medical OncologyMayo ClinicRochester
  5. 5.Department of NeurologyMayo ClinicRochester
  6. 6.Department of NeurologyMayo ClinicJacksonville
  7. 7.Roger Maris Cancer CenterFargo

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