Prospective assessment of quality of life in adult patients with primary brain tumors in routine neurooncology practice.
The aim of this article is to evaluate and assess the impact of various factors on quality of life (QOL) in adult patients with primary brain tumors seen consecutively in routine neurooncology practice. Two hundred and fifty-seven adult patients, after undergoing surgical intervention and histologically proven primary brain neoplasms were registered in the NeuroOncology Clinic at our centre during 1 full calendar year. The study included detailed neurological assessment, evaluation of QOL using EORTC questionnaire (QLQ-30) and specific Brain Cancer module (BN 20). In the present analysis, QOL scores before starting adjuvant treatment were measured and impact of patient and tumor related factors were analyzed. Baseline global QOL data of all patients (available in 243) was relatively low including in all histological tumor types. Physical function, role function, emotion function, cognitive and social function scores were 80, 78, 65.7, 70 and 70.5 (higher values better), respectively. Domains of future uncertainty, visual disorder, motor deficit, communication deficit, headache, seizures and drowsiness scores were 19.6, 18.2, 28.5, 30.7, 21, 31.8 and 16 (lower values better), respectively. Elderly patients had poorer global score (21 points difference; p = 0.161). Patients with lower performance status (KPS < 70) had a lower global QOL (KPS >or= 80 vs. <or= 70; 37 vs. 67; p = 0.001) including in all histological types of high-grade gliomas (HGG) (p = 0.005), low-grade gliomas (LGG) (p = 0.04) and benign tumors (p = <0.001). Illiterate patients had lower QOL score (p = 0.005). Tumor type is an important patient related factor that influences baseline global scores (LGG vs. HGG 62 and 52; p = 0.015). Economic status significantly influence QOL scores in HGG (p = 0.052). Type of surgery (biopsy/complete excision) (p = 0.284) and site of tumor (p = 0.309) did not show any impact on QOL score. Patients with primary brain tumours before starting adjuvant therapy have relatively low baseline quality of life scores, especially in lower economic and literacy strata. Patients with malignant tumors and poor performance status had significantly lower QOL scores even before starting adjuvant treatment.
Budrukkar
Ashwini
A
Department of Radiation Oncology and Neuro Oncology, Tata Memorial Hospital, 125, Parel, Mumbai, 400 012, India.
Jalali
Rakesh
R
Department of Radiation Oncology and Neuro Oncology, Tata Memorial Hospital, 125, Parel, Mumbai, 400 012, India. rjalali@tmc.gov.in.
Dutta
Debnarayan
D
Department of Radiation Oncology and Neuro Oncology, Tata Memorial Hospital, 125, Parel, Mumbai, 400 012, India.
Sarin
Rajiv
R
Department of Radiation Oncology and Neuro Oncology, Tata Memorial Hospital, 125, Parel, Mumbai, 400 012, India.
Devlekar
Rashmi
R
Brain Tumour Foundation of India, Mumbai, India.
Parab
Sachin
S
Brain Tumour Foundation of India, Mumbai, India.
Kakde
Anagha
A
Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, India.
D000236:Adenoma / Q000503:physiopathology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000503:physiopathology* / Q000628:therapy*; D004522:Educational Status; D005260:Female; D005910:Glioma / Q000503:physiopathology* / Q000628:therapy*; D006304:Health Status; D006801:Humans; D007194:India; D017567:Karnofsky Performance Status; D008297:Male; D008577:Meningeal Neoplasms / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010911:Pituitary Neoplasms / Q000503:physiopathology / Q000628:therapy; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult