Abstract

Abstract BACKGROUND Isocitrate dehydrogenase wild-type (IDHwt) gliomas are uncurable primary tumors of the brain and impose a high burden on affected patients and caregivers. In addition to neurological symptoms, changes in cognition and personality are common and should be diagnosed and treated early. About 75% of patients with brain tumors suffer from psychosocial distress at their first consultation. Health-related quality of life (HR-QoL) is significantly reduced by anxiety and negative mood, following glioma diagnosis. Brain tumor diagnosis also affects caregivers negatively. Recent publications show that caregiver and patient satisfaction influence each other, with caregivers generally being less satisfied than patients. In addition to specific tumor and symptomatic therapy, psycho-oncological care is an important element in a comprehensive treatment approach and may lead to increased HR-QoL and patient and caregiver satisfaction. However, there are few prospective datasets focusing on these aspects. MATERIAL AND METHODS We investigated the impact of psycho-oncological care on HR-QoL and patient and caregiver satisfaction in a large brain tumor center. Data from the regional brain tumor registry and electronic medical charts were used to compile the prospective patient cohort. Standardized questionnaires were used to investigate HR-QoL (EORTC QLQ C-30 and BN-20) and satisfaction (EORTC PATSAT-C33). Univariable and multiple linear regression analysis was applied to test the influence of psycho-oncological care on both aspects. RESULTS A homogenous cohort of 61 patients was investigated, of whom 29 (47.5%) received psycho-oncological care. We analyzed 141 EORTC QLQ-C30, 139 EORTC QLQ-BN20, 129 EORTC PATSAT-C33 questionnaires from patients, and 115 EORTC PATSAT-C33 questionnaires from caregivers. We show that patients who received at least one psycho-oncological consultation had significantly worse role functioning (p = 0.001) and a negatively influenced global health status (p = 0.038). Psycho-oncological care had no significant correlation with the satisfaction of patients. Caregivers of patients with psycho-oncological care documented inferior satisfaction with information exchange of doctors (p = 0.036). CONCLUSION We conclude that receiving psycho-oncological care is associated with changes in HR-QoL and patient and caregiver satisfaction. Utmost efforts should be made to integrate intensively and frequently psycho-oncological care on a daily-practice basis. It will be subject of future prospective studies to investigate kind and frequency of interventions that are suited to improve HR-QoL and treatment satisfaction in patients with IDHwt gliomas and their caregivers, and how to complement supportive therapies better to achieve optimal psychosocial outcomes for these patients and their caregivers.

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