Factors associated with health-related quality of life (HRQoL) deterioration in glioma patients during the progression-free survival period

Author:

Coomans Marijke B1,Dirven Linda12ORCID,Aaronson Neil3,Baumert Brigitta G45,van den Bent Martin6ORCID,Bottomley Andrew7,Brandes Alba A8,Chinot Olivier9,Coens Corneel7,Gorlia Thierry10,Herrlinger Ulrich11,Keime-Guibert Florence12,Malmström Annika13,Martinelli Francesca7,Stupp Roger14,Talacchi Andrea15,Weller Michael16ORCID,Wick Wolfgang1718ORCID,Reijneveld Jaap C19,Taphoorn Martin J B12

Affiliation:

1. Department of Neurology, Leiden University Medical Center , Leiden , the Netherlands

2. Department of Neurology, Haaglanden Medical Center , Den Haag , the Netherlands

3. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute , Amsterdam , the Netherlands

4. Institute of Radiation-Oncology, Kantonsspital Graubünden , Chur , Switzerland

5. Department of Radiation Oncology (MAASTRO Clinic), and GROW (School for Oncology and Developmental Biology), Maastricht University Medical Center , Maastricht , the Netherlands

6. The Brain Tumor Center, Erasmus MC Cancer Institute , Rotterdam , the Netherlands

7. Quality of Life Department, European Organisation for Research and Treatment of Cancer , Brussels , Belgium

8. Department of Medical Oncology, Azienda USL-IRCCS Institute of Neurological Sciences , Bologna , Italy

9. Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service de Neuro-Oncologie , Marseille , France

10. European Organization for Research and Treatment of Cancer, Headquarters , Brussels , Belgium

11. Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center , Bonn , Germany

12. Groupe Hôpital Pitié-Salpetrière , Assistance Publique, Paris , France

13. Department of Advanced Home Care and Department of Clinical and Experimental Medicine, Linköping University , Linköping , Sweden

14. Northwestern University, Feinberg School of Medicine , Chicago, Illinois, USA

15. Department of Neurosciences, Azienda Ospedaliera San Giovanni Addolorata , Roma , Italia

16. Department of Neurology, University Hospital and University of Zurich , Zurich , Switzerland

17. Neurology Clinic and National Centre for Tumour Diseases, University Hospital Heidelberg , Heidelberg , Germany

18. German Consortium of Translational Cancer Research (DKTK), Clinical Cooperation Unit Neurooncology, German Cancer Research Center , Heidelberg , Germany

19. Department of Neurology and Brain Tumour Center Amsterdam, Amsterdam University Medical Center , Amsterdam , the Netherlands

Abstract

Abstract Background Maintenance of functioning and well-being during the progression-free survival (PFS) period is important for glioma patients. This study aimed to determine whether health-related quality of life (HRQoL) can be maintained during progression-free time, and factors associated with HRQoL deterioration in this period. Methods We included longitudinal HRQoL data from previously published clinical trials in glioma. The percentage of patients with stable HRQoL until progression was determined per scale and at the individual patient level (i.e. considering all scales simultaneously). We assessed time to a clinically relevant deterioration in HRQoL, expressed in deterioration-free survival and time-to-deterioration (the first including progression as an event). We also determined the association between sociodemographic and clinical factors and HRQoL deterioration in the progression-free period. Results Five thousand five hundred and thirty-nine patients with at least baseline HRQoL scores had a median time from randomization to progression of 7.6 months. Between 9–29% of the patients deteriorated before disease progression on the evaluated HRQoL scales. When considering all scales simultaneously, 47% of patients deteriorated on ≥1 scale. Median deterioration-free survival period ranged between 3.8–5.4 months, and median time-to-deterioration between 8.2–11.9 months. For most scales, only poor performance status was independently associated with clinically relevant HRQoL deterioration in the progression-free period. Conclusions HRQoL was maintained in only 53% of patients in their progression-free period, and treatment was not independently associated with this deterioration in HRQoL. Routine monitoring of the patients’ functioning and well-being during the entire disease course is therefore important, so that interventions can be initiated when problems are signaled.

Funder

European Organisation for Research and Treatment of Cancer

Quality of Life Group

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Neurology (clinical),Oncology

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