Abstract
ObjectiveHalf of all newly diagnosed patients with glioblastoma are > 65 years still with a poor prognosis. Preserving quality of life is of high importance. However, patient reported outcome (PRO) data in this patient group is rare. The aim was to compare health-related quality of life (HRQoL) and distress between elderly and younger patients with high-grade glioma (HGG).MethodsWe used baseline data of a prospective study where HGG patients were enrolled from 4 hospitals. Distress was measured using the distress thermometer (DT), HRQoL using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) plus brain module (BN20). We compared distress and HRQoL by age (≥ 65 vs. < 65 years), gender, performance score, and time since diagnosis using multivariate linear and logistic regressions.ResultsA total of n = 93 (30%) out of n = 309 patients were ≥ 65 years (mean 70 years, range 65–86 years). Mean DT score of elderly patients (5.2, SD 2.6) was comparable with younger patients (4.9, SD 2.6). Elderly patients reported significantly lower global health (GHS, mean elderly vs. younger; 50.8 vs. 60.5, p = 0.003), worse physical (56.8 vs. 73.3, p < 0.001) and lower cognitive functioning (51.1 vs. 63.2, p = 0.002), worse fatigue (52.5 vs. 43.5, p = 0.042), and worse motor dysfunction (34.9 vs. 23.6, p = 0.030). KPS and not age was consistently associated with HRQoL.ConclusionPhysical functioning was significantly reduced in the elderly compared with younger HGG patients, and at the same time, emotional functioning and DT scores were comparable. KPS shows a greater association with HRQoL than with calendric age in HGG patients reflecting the particular importance for adequate assessment of HRQoL and general condition in elderly patients.
Highlights
High-grade gliomas (HGG) represent the majority of gliomas with glioblastomas showing an incidence of 3.19 (3.16–3.21) cases per 100,000 person years [1]
It has been reported that lower performance status, higher age, female gender, and shorter time since diagnosis can be associated with distress and reduced quality of life [5]
Health-related quality of life (HRQoL) data is rare for elderly people with HGG, and as soon as they experience clinical decline due to disease progression, assessment becomes difficult [2, 5]
Summary
High-grade gliomas (HGG) represent the majority of gliomas with glioblastomas showing an incidence of 3.19 (3.16–3.21) cases per 100,000 person years [1]. Half of all newly diagnosed patients with glioblastoma (GBM) are older than 65 years [2]. Higher age is an exclusion criterion, and historically, many elderly patients received no tumor-specific therapy but best supportive care [7, 8]. Preserving quality of life in elderly patients is of high importance considering the short life expectancy. Distress and supportive care needs in HGG patients are high. They should be addressed early in the disease trajectory by psycho-oncologists and supportive and palliative care services [12]. It has been reported that lower performance status, higher age, female gender, and shorter time since diagnosis can be associated with distress and reduced quality of life [5]. Health-related quality of life (HRQoL) data is rare for elderly people with HGG, and as soon as they experience clinical decline due to disease progression, assessment becomes difficult [2, 5]
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