A prospective study of quality of life in adults with newly diagnosed high-grade gliomas: the impact of the extent of resection on quality of life and survival

• Published in: Neurosurgery Vol. 57; no. 3; p. 495
• Main Authors: Brown, Paul D, Maurer, Matthew J, Rummans, Teresa A, Pollock, Bruce E, Ballman, Karla V, Sloan, Jeff A, Boeve, Bradley F, Arusell, Robert M, Clark, Matthew M, Buckner, Jan C
• Format: Journal Article
• Language: English
• Published: United States 01.09.2005
• Subjects: Adult; Aged; Brain Neoplasms - mortality; Brain Neoplasms - psychology; Brain Neoplasms - therapy; Clinical Trials, Phase II as Topic; Drug Therapy; Female; Follow-Up Studies; Glioma - mortality; Glioma - psychology; Glioma - therapy; Humans; Logistic Models; Male; Middle Aged; Proportional Hazards Models; Prospective Studies; Quality of Life; Radiotherapy; Survival Analysis; Time Factors
• ISSN: 1524-4040
• DOI: 10.1227/01.NEU.0000170562.25335.C7

To describe the quality of life (QOL) over time for adults with newly diagnosed high-grade gliomas and to examine the relationship between QOL and outcome data collected in three prospective cooperative group clinical trials. The QOL study was a companion protocol for three Phase II high-grade glioma protocols. Five self-administered forms were completed by patients to assess QOL at study entry, 2 months, and 4 months after enrollment. QOL data were available for baseline, first, and second subsequent follow-up evaluations for 89%, 71%, and 69% of patients, respectively. A significant proportion of patients (47.1%) experienced impaired QOL (QOL < or = 50) in at least one measure at subsequent evaluations, whereas most patients (88%) with impaired QOL at baseline continued to have impaired QOL at subsequent evaluations. On multivariable analyses, baseline QOL measures were predictive of QOL at the time of follow-up. In addition, patients who underwent a gross total resection were much less likely to have impaired QOL (P = 0.006), were less likely to experience worsening depression (P = 0.0008), and were more likely to have improved QOL (P = 0.003) at their first follow-up evaluation. Changes in QOL measures over time were not found to be associated with survival in multivariable analyses that adjusted for known prognostic variables; variables that were independently associated with improved survival were better performance status (P < 0.001), younger age (P < 0.001), and greater extent of resection (P < 0.001). Baseline QOL was predictive of QOL over time. Gross total resection was associated with longer survival and improved QOL over time for patients with high-grade gliomas.