title: A prospective study of quality of life in adults with newly diagnosed high-grade gliomas: the impact of the extent of resection on quality of life and survival.
abstract: OBJECTIVE
  To describe the quality of life (QOL) over time for adults with newly diagnosed high-grade gliomas and to examine the relationship between QOL and outcome data collected in three prospective cooperative group clinical trials.
  
  
  METHODS
  The QOL study was a companion protocol for three Phase II high-grade glioma protocols. Five self-administered forms were completed by patients to assess QOL at study entry, 2 months, and 4 months after enrollment.
  
  
  RESULTS
  QOL data were available for baseline, first, and second subsequent follow-up evaluations for 89%, 71%, and 69% of patients, respectively. A significant proportion of patients (47.1%) experienced impaired QOL (QOL < or = 50) in at least one measure at subsequent evaluations, whereas most patients (88%) with impaired QOL at baseline continued to have impaired QOL at subsequent evaluations. On multivariable analyses, baseline QOL measures were predictive of QOL at the time of follow-up. In addition, patients who underwent a gross total resection were much less likely to have impaired QOL (P = 0.006), were less likely to experience worsening depression (P = 0.0008), and were more likely to have improved QOL (P = 0.003) at their first follow-up evaluation. Changes in QOL measures over time were not found to be associated with survival in multivariable analyses that adjusted for known prognostic variables; variables that were independently associated with improved survival were better performance status (P < 0.001), younger age (P < 0.001), and greater extent of resection (P < 0.001).
  
  
  CONCLUSIONS
  Baseline QOL was predictive of QOL over time. Gross total resection was associated with longer survival and improved QOL over time for patients with high-grade gliomas.
authors.affiliation: Division of Radiation Oncology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Brown
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Maurer
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Rummans
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Pollock
authors.forename: Karla V
authors.initials: KV
authors.lastname: Ballman
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Bradley F
authors.initials: BF
authors.lastname: Boeve
authors.forename: Robert M
authors.initials: RM
authors.lastname: Arusell
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.forename: Jan C
authors.initials: JC
authors.lastname: Buckner
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D017322:Clinical Trials, Phase II as Topic; D004358:Drug Therapy; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D011878:Radiotherapy; D016019:Survival Analysis; D013997:Time Factors