QOL-03OVERALL SURVIVAL AND HEALTH-RELATED QUALITY OF LIFE IN RECURRENT GLIOBLASTOMA PATIENTS RECEIVING INTRA-ARTERIAL CARBOPLATIN AFTER STANDARD CARE

Abstract

INTRODUCTION: Prognosis for glioblastoma (GBM) remains dire with a reported median survival of 14.6 months. Various aggressive treatment regimens have been pursued, in certain instances with a negative impact on Heath-Related Quality of Life (HR-QOL), with modest survival benefits. In this prospective study, we describe our experience in patient reported HR-QOL and survival benefit of an intra-arterial (IA) carboplatin-based treatment for recurrent GBM in combination with other cytotoxic agents. METHODS: Adult patients with recurrent GBM treated with 400 mg/m2 IA carboplatin every 4 weeks were enrolled in this study. Additionally, patients received (a)10 mg/kg bevacizumab every 2 weeks or (b) 660 mg/m2 cyclophosphamide and 400 mg/m2 etoposide every 4 weeks. HR-QOL was measured specific time-points with EORTC QLQ-30 & BN-20 questionnaires. HR-QOL scores of 7 selected domains expected to be most affected in GBM patients were studied. Patients were followed for treatment-related adverse events and overall survival. RESULTS: The study cohort comprised of 24 patients with a median age of 49.5 years. The most prevalent neurological complications reported were headaches (n = 10) and focal seizures (n = 5). A majority of the patients (n = 14) reported nausea and fatigue. Groin hematoma at catheter insertion site was noted in 4 patients and visual deficit in 5 patients. Grade 4 thrombocytopenia was observed in 4 patients and 3 patients had strokes. Longitudinal global-QOL scores were maintained or improved in a majority of patients, prior to disease progression. For this cohort, median overall survival was 25 months (range, 16-30) with 6 surviving patients at the end of the follow-up period. CONCLUSION: IA chemotherapy with carboplatin is a relatively safe and well tolerated treatment in recurrent GBM demonstrating encouraging outcomes in terms of overall survival in a selected group of patients. In addition, there were no significant unfavorable effects on HRQOL scores noted in the 7 preselected domains.