PCSM-06COMPARISON OF THE SYMPTOM BURDEN IN ACTIVE TREATMENT VERSUS FOLLOW-UP FOR PRIMARY BRAIN TUMOR PATIENTS

Abstract

BACKGROUND: Primary Brain Tumor (PBT) patients have unique symptoms compared with patients with systemic cancers, likely related to involvement of the central nervous system. Despite aggressive treatment, declaration of true remission is difficult because of the high rate of recurrence. The purpose of this study was to compare the symptom experience of patients in follow-up with those undergoing active treatment. METHODS: Cross-sectional patient-reported outcome symptom data (M.D. Anderson Symptom Inventory-Brain Tumor) measuring both core oncology and PBT-specific symptoms was collected. Active-treatment and follow-up groups were compared for each of 22 symptom items in terms of symptom severity, number of symptoms and differences in overall severity. Six functional symptom groupings and group differences were assessed with linear regression. FINDINGS: The sample included 488 patients (273 on active treatment; 215 follow-up). The on-treatment group was significantly older [48.83 years (18-79) vs 44.46 years (18-84)] and more likely to have a glioblastoma (p < 0.0001). Mean symptom severity was not significantly different between groups [on-treatment 1.64 (0-7.36), follow-up 1.57 (0-6.36), p = 0.5747]. Patients on treatment reported higher symptom prevalence for 8 of 22 items. They reported more moderate/severe nausea (p = 0.0409) and bowel problems (p = 0.0029), with higher aggregate general symptom (p = 0.0044) and GI symptom (p = 0.0044) scores. After adjusting for age and KPS, the number of symptoms were not different between groups (p = 0.2346), but general (p = 0.0407) and GI (0.0056) symptoms were more severe in those on active treatment. CONCLUSION: This preliminary analysis shows that PBT patients on active treatment have more severe treatment-associated symptoms. However, patients in follow-up have disease-related symptoms, number of symptoms and overall symptom burden as severe as those on treatment. These findings underscore the need for disease-related symptom management for both groups and additional research to determine factors that explain symptom pattern over the course of the disease.