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Clinical Therapy Trials—Quality of Life |
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (D.O.); Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, UK (M.B.); M787 Department of Neurosurgery, University of California, San Francisco, CA 94143 (M.D.P.); Department of Neuro-Oncology, M.D. Anderson Cancer Center, Houston, TX 77030 (W.K.A.Y.)
2 Address correspondence and reprint requests to David Osoba, QOL Consulting, 4939 Edendale Ct., West Vancouver, BC, Canada V7W 3H7.
Abstract
The burden imposed by disease recurrence in patients with high-grade
gliomas is not well documented. We studied the frequency of self-report
symptoms and the effects on health-related quality of life in patients who had
recurrent glioblastoma multiforme or anaplastic astrocytoma and who had a
Karnofsky performance score 
70. Patients completed the European
Organization for Research and Treatment of Cancer Quality of Life
Questionnaire-Core 30 Items (QLQ-C30) and the Brain Cancer Module (BCM20)
before initiation of treatment for first recurrence of disease. Six symptoms
(fatigue, uncertainty about the future, motor difficulties, drowsiness,
communication difficulties, and headache) were reported with a frequency
>50% by both groups of patients. An additional two symptoms (visual
problems and pain) were also reported with frequencies of >50% by patients
with recurrent glioblastoma multiforme. Most of the symptoms were likely due
to recurrence, but previous radiation therapy and on-going corticosteroid
treatment may have also been casual factors for fatigue, whereas uncertainty
about the future and pain were probably nonspecific for brain cancer. Problems
with motor functioning, vision, leg strength, and pain were reported more
frequently by patients with recurrent glioblastoma multiforme than by those
with recurrent anaplastic astrocytoma. Scores on health-related
quality-of-life functioning scales were similar in the two groups. Finally,
the scores for patients who had recurrent high-grade gliomas and a Karnofsky
performance score 70 were compared with the reported health-related
quality of life scores of patients with other cancers. Their scores were
similar to those of patients with metastatic cancers and worse than those of
patients with localized cancers.
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