title: Prognostic value of health-related quality of life for death risk stratification in patients with unresectable glioblastoma.
abstract: Glioblastoma is the most common malignant brain tumor in adults. Baseline health-related quality of life (HRQoL) is a major subject of concern for these patients. We aimed to assess the independent prognostic value of HRQoL in unresectable glioblastoma (UGB) patients for death risk stratification. One hundred and thirty-four patients with UGB were enrolled from the TEMAVIR trial. HRQoL was evaluated at baseline using the EORTC QLQ-C30 and BN20 brain cancer module. Clinical and HRQoL parameters were evaluated in univariable and multivariable Cox analysis as prognostic factors for overall survival (OS). Performance assessment and internal validation of the final model were evaluated with Harrel's C-index, calibration plot, and bootstrap sample procedure. Two OS independent predictors were identified: future uncertainty and sensitivity deficit. The final model exhibited good calibration and acceptable discrimination (C statistic = 0.63). The internal validity of the model was verified with robust uncertainties around the hazard ratio. The prognostic score identified three groups of patients with distinctly different risk profiles with median OS estimated at 16.2, 9.2, and 4.5 months. We demonstrated the additional prognostic value of HRQoL in UGB for death risk stratification and provided a score that may help to guide clinical management and stratification in future clinical trials.
authors.affiliation: Methodological and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, EA 3181, France.|Department of Digestive Surgery and Liver Transplantation, University Hospital of Besançon, Besançon, France.
authors.forename: Brice
authors.initials: B
authors.lastname: Paquette
authors.affiliation: Methodological and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, EA 3181, France.
authors.forename: Dewi
authors.initials: D
authors.lastname: Vernerey
authors.affiliation: Department of Medical Oncology, University Hospital, EA 4666, Amiens, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Chauffert
authors.affiliation: Biostatistics and Quality of life Unit, Centre Georges François Leclerc, Dijon, France.|Quality of Life in Oncology National Platform, Besançon, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Dabakuyo
authors.affiliation: Department of Radiotherapy, Pitié-Salpetrière University Hospital, Paris, France.
authors.forename: Loic
authors.initials: L
authors.lastname: Feuvret
authors.affiliation: Department of Neurology, University Hospital, Nancy, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Taillandier
authors.affiliation: Department of Oncology, Leon Berard Centre for Fight against Cancer, Lyon, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Frappaz
authors.affiliation: Department of Neurology, HIA Val de Grace, Paris, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Taillia
authors.affiliation: Department of Oncology, Paul Strauss Centre for Fight against Cancer, Strasbourg, France.
authors.forename: Roland
authors.initials: R
authors.lastname: Schott
authors.affiliation: Department of Neurology, University Hospital, Lyon, France.
authors.forename: François
authors.initials: F
authors.lastname: Ducray
authors.affiliation: Department of Oncology, Val d'Aurelle Center for Fight against Cancer, Montpellier, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Fabbro
authors.affiliation: Department of Oncology, Henri Becquerel Center for Fight against Cancer, Rouen, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Tennevet
authors.affiliation: Department of Oncology, GF Leclerc Center for Fight against Cancer, Dijon, France.
authors.forename: François
authors.initials: F
authors.lastname: Ghiringhelli
authors.affiliation: Department of Neurology, University Hospital, Caen, France.
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Guillamo
authors.affiliation: Department of Oncology, Jean Perrin Center for Fight against Cancer, Clermont-Ferrand, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Durando
authors.affiliation: Clinique Saint Pierre, Perpignan, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Castera
authors.affiliation: Department of Oncology, Antoine Lacassagne Center for Fight against Cancer, Nice, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Frenay
authors.affiliation: Department of Neurology, University Hospital, Nimes, France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Campello
authors.affiliation: Biostatistics and Quality of life Unit, Centre Georges François Leclerc, Dijon, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Dalban
authors.affiliation: Methodology Unit, GF Leclerc Center for Fight against Cancer, Dijon, France.
authors.forename: Jérome
authors.initials: J
authors.lastname: Skrzypski
authors.affiliation: Department of Neuro-Oncology, University Hospital La Timone, Marseille, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Chinot
authors.affiliation: Methodological and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, EA 3181, France.|Quality of Life in Oncology National Platform, Besançon, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Anota
authors.affiliation: Methodological and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, EA 3181, France.|Quality of Life in Oncology National Platform, Besançon, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Bonnetain
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000534:rehabilitation*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D059248:Chemoradiotherapy / Q000379:methods; D017024:Chemotherapy, Adjuvant; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005909:Glioblastoma / Q000534:rehabilitation*; D006801:Humans; D000077146:Irinotecan; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011594:Psychometrics; D011788:Quality of Life; D000077204:Temozolomide
chemical_list: D000068258:Bevacizumab; D000077146:Irinotecan; D003606:Dacarbazine; D002166:Camptothecin; D000077204:Temozolomide
keywords: Health-related quality of life; overall survival; prognostic score; risk stratification; unresectable glioblastoma