Prospective NCCTG quality of life (QOL) study in adult newly diagnosed high-grade gliomas (HGG)

Abstract

1524 Background: To assess QOL and the prognostic importance of QOL in adult patients with newly diagnosed high grade gliomas (HGG), QOL and outcome data collected in three prospective cooperative group clinical trial were analyzed. Methods: The QOL study was a companion protocol for three phase II protocols; 98–72-51 and 98–72-52 examined pre-irradiation and concurrent chemotherapy with radiation therapy for patients with anaplastic astrocytomas and glioblastomas (GBM) respectively, while N0074 investigated maintenance EGFR inhibitor after radiation was completed for GBMs. At study entry and at regular intervals, 5 self-administered forms were completed by the patient to assess (i) overall QOL (Linear Analogue Scale [LASA] and the Functional Assessment of Cancer Therapy-Brain [FACT-BR Version 4]), (ii) fatigue (Profiles of Mood States short form [POMS-SF] and the Symptom Distress Scale [SDS]), (iii) excessive daytime somnolence (Epworth Sleepiness Scale [ESS]), and (iv) depression (Profiles of Mood States short form [POMS-SF]). Results: Baseline and subsequent QOL data was available for 131 of 220 (60 %) patients enrolled in the 3 prospective trials. A significant proportion of patients became clinically distressed (QOL ≤ 50) at subsequent evaluations, while the majority of patients distressed at baseline remained distressed at subsequent evaluations. Increased fatigue (SDS, p=0.05), depression (p=0.05), and worse QOL (LASA, p=0.02) at baseline were predictive of worse survival. Subsequent development of clinical distress was not predictive of survival. Conclusions: A significant proportion of patients with HGG become clinically distressed after treatment. The majority of patients distressed at baseline remain distressed after treatment. Increased fatigue, depression, and worse QOL at baseline predict a worse survival. Interventional studies directed to improving QOL are needed. No significant financial relationships to disclose.