Abstract

PURPOSEMeasurement of quality of life (QOL) of patients with brain tumors is a challenge, because parameters of the established QOL scales for cancer patients are easily affected by the focal neurological deficits. Thus, simpler QOL scales which are feasible for evaluation of QOL with severe neurological deficits are required. We compared the results of four QOL scales in patients with brain tumors.METHODSFrom 2015 to 2018, we prospectively performed EORTC QLQ-C30/BN20 (C30/BN20), KPS, EQ-5D and “Distress and Impact Thermometer (DIT)” every three months.RESULTS2150 QOL evaluations from 710 patients were analyzed. The median age was 54 years (range 14–97). 319 glioma, 93 meningioma, 165 brain metastases and 133 other brain tumors were included. Global health status of C30/BN20 strongly correlated with QOL scores calculated by EQ-5D and DIT; it also showed correlation with KPS (correlation coefficients: 0.632, -0.675, -0.622, 0.412, respectively (p<0.001)). Most items of C30/BN20 showed relatively strong correlation with QOL scores, whereas KPS strongly correlated to physical activities and DIT strongly correlated to items related to psychological status. Seizures did not corelate with any other QOL scales. In patients with KPS≤60, wide dispersion of QOL scores and DIT were observed. In these patients, KPS correlated only with items 1–3 of EQ-5D and DIT with item 5. When time course of QOL scores in malignant glioma was evaluated, it was maintained until first remission, and significantly impaired at recurrence, compared to onset (p=0.014).CONCLUSIONQOL scores can be used as an alternative for C30/BN20, and QOL time course of glioma can be adequately evaluated with it. KPS and DIT can also be alternative scales. These two scales should desirably be used in combination in patients with low KPS. Evaluations of feasibility and validity of these QOL scales in patients who cannot answer C30/BN20 are warranted.

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