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Clinical Investigations |
1 Department of Neurology, VU University Medical Center, Amsterdam
2 Department of Neurology, VU University Medical Center, Amsterdam; Department of Neurology, Academic Medical Center, Amsterdam
3 Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam
4 Neurosurgical Center Amsterdam
5 Department of Radiation Oncology, VU University Medical Center, Amsterdam
6 Department of Neurology, VU University Medical Center, Amsterdam; Department of Neurology, Medical Center Haaglanden
7 Department of Medical Psychology, VU University Medical Center, Amsterdam
* To whom correspondence should be addressed. E-mail: i.bosma{at}vumc.nl.
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Abstract |
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Objective: 1) to compare the health-related quality of life (HRQoL) of long-term to short-term high-grade glioma (HGG) survivors, 2) to determine the prognostic value of HRQoL for overall survival, and 3) to determine the effect of tumor recurrence on HRQoL of long-term survivors.
Methods: Following baseline assessment (after surgery, before radiotherapy), self-perceived HRQoL (MOS SF-36) and brain tumor-specific symptoms (BCM-20) were assessed every 4 months up till 16 months after histological diagnosis. Kaplan-Meier survival analysis and the Cox proportional hazards model were performed to estimate overall survival of patients with impaired scores on the aggregated SF-36 higher-order summary scores measuring physical functioning (PCS) and mental functioning (MCS).
Results: Sixteen patients with a short-term survival (baseline and 4-month follow-up) and 16 with a long-term survival (follow-up up till 16 months after diagnosis) were selected out of 68 initially recruited HGG patients. At baseline, the short-term and long-term survivors did not differ in their HRQoL. Between baseline and 4-month follow-up, HRQoL of short-term survivors deteriorated, whereas the long-term survivors improved to a level comparable to healthy controls. Patients with impaired mental functioning (MCS) at baseline had a shorter median survival than patients with a normal functioning. Accounting for differences in patient and tumor characteristics, it was not independently related to poorer overall survival. Not surprisingly in the group of long-term survivors, the 5 patients with recurrence had a more compromised HRQoL at 16-month follow-up compared to the 11 patients without recurrence.
Conclusion: 1) Baseline HRQoL is not related to duration of survival. 2) Long-term survivors show improvement of HRQoL to a level comparable to that of the healthy.
Key Words: High-grade glioma survivors, HRQoL
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