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Quality of Life in Low-Grade Gliomas

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Diffuse Low-Grade Gliomas in Adults

Abstract

Outcome measures for brain tumor patients have traditionally been confined to survival and radiological response to treatment. The recognition that duration of survival may not be the only goal of treatment has resulted in health-related quality of life (HRQOL) to become an important (secondary) outcome. It is generally acknowledged that the benefits of longer survival due to tumor treatment should be weighed against side effects of treatment which may have a negative impact on the patient’s functioning in physical, psychological, and social aspects.

For low-grade glioma (LGG) patients, outcome measures should include neurocognitive functioning and severity of epilepsy apart from patient-reported measures such as HRQOL. Since these patients have a relatively extended survival compared to high-grade glioma, and may therefore run the risk of long-term complications due to the tumor and treatment, these outcomes are now considered to be of major importance in clinical trials.

From clinical studies we have learned that cognitive deficit and severity of epilepsy in LGG patients have a negative impact on HRQOL.

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References

  1. Taphoorn MJ, Klein M. Cognitive deficits in adult patients with brain tumours. Lancet Neurol. 2004;3:159–68.

    Article  PubMed  Google Scholar 

  2. Efficace F, Bottomley A. Health-related quality of life assessment methodology and reported outcomes in randomised controlled trials of primary brain cancer. Eur J Cancer. 2002;38:1824–31.

    Article  PubMed  CAS  Google Scholar 

  3. Van den Bent MJ, Wefel JS, Schiff D, et al. Response assessment in neuro-oncology (a report of the RANO group): assessment of outcome in trials of diffuse low-grade gliomas. Lancet Neurol. 2011;12:583–93.

    Google Scholar 

  4. Klein M. Health-related quality of life aspects in patients with low-grade glioma. Adv Tech Stand Neurosurg. 2010;35:213–35.

    Article  PubMed  CAS  Google Scholar 

  5. Grant R, Slattery J, Gregor A, Whittle IR. Recording neurological impairment in clinical trials of glioma. J Neurooncol. 1994;19:39–47.

    Google Scholar 

  6. Karnofsky DA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. In: Macleod CM, editor. Evaluation of chemotherapeutic agents. New York: Columbia University Press; 1949. p. 191–205.

    Google Scholar 

  7. Taphoorn MJB, Sizoo EM, Bottomley A. Review on quality of life issues in patients with primary brain tumors. Oncologist. 2010;15:618–26.

    Article  PubMed  Google Scholar 

  8. Armstrong TS, Gilbert MR. Net clinical benefit: functional endpoints in brain tumor clinical trials. Curr Oncol Rep. 2007;9:60–5.

    Article  PubMed  Google Scholar 

  9. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352:987–96.

    Article  PubMed  CAS  Google Scholar 

  10. Klein M, Engelberts NH, van der Ploeg HM, et al. Epilepsy in low-grade gliomas: the impact on cognitive function and quality of life. Ann Neurol. 2003;54:514–20.

    Article  PubMed  Google Scholar 

  11. Aaronson NK, Taphoorn MJB, Heimans JJ, et al. Compromised health-related quality of life in patients with low-grade glioma. J Clin Oncol. 2011;29:4430–5.

    Article  PubMed  Google Scholar 

  12. Wieser HG, Blume WT, Fish D, et al. ILAE Commission Report. Proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery. Epilepsia. 2001;42:282–6.

    Article  PubMed  CAS  Google Scholar 

  13. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–76.

    Article  PubMed  CAS  Google Scholar 

  14. Gill TM, Feinstein AR. A critical appraisal of the quality of quality-of-life measurements. JAMA. 1994;272:619–26.

    Article  PubMed  CAS  Google Scholar 

  15. Weitzner MA, Meyers CA, Gelke CK, Byrne KS, Cella DF, Levin VA. The functional assessment of cancer therapy (FACT) scale. Development of a brain subscale and revalidation of the general version (FACT-G) in patients with primary brain tumors. Cancer. 1995;75:1151–61.

    Article  PubMed  CAS  Google Scholar 

  16. Osoba D, Aaronson NK, Muller M, et al. The development and psychometric validation of a brain cancer quality-of-life questionnaire for use in combination with general cancer-specific questionnaires. Qual Life Res. 1996;5:139–50.

    Article  PubMed  CAS  Google Scholar 

  17. Taphoorn MJ, Claassens L, Aaronson NK, EORTC Quality of Life Group, and Brain Cancer, NCIC and Radiotherapy Groups, et al. An international validation study of the EORTC brain cancer module (EORTC QLQ-BN20) for assessing health-related quality of life and symptoms in brain cancer patients. Eur J Cancer. 2010;46:1033–40.

    Article  PubMed  Google Scholar 

  18. Fayers P, Bottomley A. Quality of life research within the EORTC: the EORTC QLQ-C30. European Organisation for Research and Treatment of Cancer. Eur J Cancer. 2002;38(S4):125–33.

    Article  Google Scholar 

  19. Fayers P, Aaronson N, Bjordal K, et al. EORTC QLQ-C30 scoring manual. 3rd ed. Brussels: EORTC Publications; 2001.

    Google Scholar 

  20. Osoba D, Rodrigues G, Myles J, et al. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol. 1998;16:139–44.

    PubMed  CAS  Google Scholar 

  21. Armstrong TS, Mendoza T, Gning I, et al. Validation of the M.D. Anderson Symptom Inventory Brain Tumor Module (MDASI-BT). J Neurooncol. 2006;80:27–35.

    Article  PubMed  CAS  Google Scholar 

  22. Recht L, Glantz M, Chamberlain M, Hsieh CC. Quantitative measurement of quality outcome in malignant glioma patients using an independent living score (ILS). Assessment of a retrospective chart. J Neurooncol. 2003;61:127–36.

    Article  PubMed  CAS  Google Scholar 

  23. Stewart AL, Ware Jr JE. Measuring functioning and well-being: the Medical Outcomes Study approach. Durham: Duke University Press; 1992.

    Google Scholar 

  24. Walker M, Brown J, Brown K, Gregor A, Whittle IR, Grant R. Practical problems with the collection and interpretation of serial quality of life assessments in patients with malignant glioma. J Neurooncol. 2003;63:179–86.

    Article  PubMed  CAS  Google Scholar 

  25. Taphoorn MJB, van den Bent MJ, Mauer ME, et al. Health-related quality of life in patients treated for anaplastic oligodendroglioma with adjuvant chemotherapy: results of a European Organisation for Research and Treatment of Cancer randomized clinical trial. J Clin Oncol. 2007;25:5723–30.

    Article  PubMed  Google Scholar 

  26. Holzner B, Schauer-Maurer G, Stockhammer G, Muigg A, Hutterer M, Giesinger J. Patient reported outcome monitoring using a tablet PC is suitable for measuring quality of life in patients with gliomas. Wien Med Wochenschr. 2011;161:6–12.

    Article  PubMed  Google Scholar 

  27. Davies E, Clarke C. Views of bereaved relatives about quality of survival after radiotherapy for malignant cerebral glioma. J Neurol Neurosurg Psychiatry. 2005;76:555–61.

    Article  PubMed  CAS  Google Scholar 

  28. Sneeuw KC, Sprangers MA, Aaronson NK. The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease. J Clin Epidemiol. 2002;55:1130–43.

    Article  PubMed  Google Scholar 

  29. Brown PD, Decker PA, Rummans TA, et al. A prospective study of quality of life in adults with newly diagnosed high-grade gliomas: comparison of patient and caregiver ratings of quality of life. Am J Clin Oncol. 2008;31:163–8.

    Article  PubMed  Google Scholar 

  30. Giesinger JM, Golser M, Erharter A, et al. Do neurooncological patients and their significant others agree on quality of life ratings? Health Qual Life Outcomes. 2009;7:87.

    Article  PubMed  Google Scholar 

  31. Hochberg FH, Slotnick B. Neuropsychologic impairment in astrocytoma survivors. Neurology. 1980;30:172–7.

    Article  PubMed  CAS  Google Scholar 

  32. Imperato JP, Paleologos NA, Vick NA. Effects of treatment on long-term survivors with malignant astrocytomas. Ann Neurol. 1990;28:818–22.

    Article  PubMed  CAS  Google Scholar 

  33. Surma-aho O, Niemela M, Vilkki J, et al. Adverse long-term effects of brain radiotherapy in adult low-grade glioma survivors. Neurology. 2001;56:1285–90.

    Article  PubMed  CAS  Google Scholar 

  34. Klein M, Heimans JJ, Aaronson NK, et al. Mid- to long-term cognitive sequelae in low-grade gliomas: the impact of radiotherapy and other treatment-related factors. Lancet. 2002;360:1361–8.

    Article  PubMed  CAS  Google Scholar 

  35. Brown PD, Jensen AW, Felten SJ, et al. Detrimental effects of tumor progression on cognitive function of patients with high-grade glioma. J Clin Oncol. 2006;24:5427–33.

    Article  PubMed  Google Scholar 

  36. Correa D, DeAngelis LM, Shi W, Thaler HT, Lin M, Abrey LE. Cognitive functions in low-grade gliomas: disease and treatment effects. J Neurooncol. 2007;81:175–84.

    Article  PubMed  Google Scholar 

  37. Douw L, Klein M, Fagel SS, et al. Cognitive and radiological effects of radiotherapy in patients with low-grade glioma: long-term follow-up. Lancet Neurol. 2009;8:810–8.

    Article  PubMed  Google Scholar 

  38. Leibel SA, Gutin PH, Wara WM, et al. Survival and quality of life after interstitial implantation of removable high-activity Iodine-125 for the treatment of patients with recurrent malignant gliomas. Int J Radiat Oncol Biol Phys. 1989;17:1129–39.

    Article  PubMed  CAS  Google Scholar 

  39. Sachsenheimer W, Piotrowski W, Bimmler T. Quality of life in patients with intracranial tumors on the basis of Karnofsky’s performance status. J Neurooncol. 1992;13:177–81.

    Article  PubMed  CAS  Google Scholar 

  40. Reijneveld JC, Sitskoorn MM, Klein M, et al. Cognitive status and quality of life in patients with suspected versus proven low-grade gliomas. Neurology. 2001;56:618–23.

    Article  PubMed  CAS  Google Scholar 

  41. Gustafsson M, Edvardsson T, Ahlström G. The relationship between function, quality of life and coping in patients with low-grade gliomas. Support Care Cancer. 2006;14:1205–12.

    Article  PubMed  Google Scholar 

  42. Struik K, Klein M, Heimans JJ, et al. Fatigue in low-grade glioma. J Neurooncol. 2009;92:73–8.

    Article  PubMed  Google Scholar 

  43. Edvardsson TI, Ahlström GI. Subjective quality of life in persons with low-grade glioma and their next of kin. Int J Rehabil Res. 2009;32:64–70.

    Article  PubMed  Google Scholar 

  44. Yavas C, Zorlu F, Ozyigit G, et al. Prospective assessment of health-related quality of life in patients with low-grade glioma: a single-center experience. Support Care Cancer. 2012;20(8):1859–68.

    Article  PubMed  Google Scholar 

  45. Salo J, Niemela A, Joukamaa M, et al. Effect of brain tumour laterality on patients’ perceived quality of life. J Neurol Neurosurg Psychiatry. 2002;72:373–7.

    Article  PubMed  CAS  Google Scholar 

  46. Osoba D, Aaronson NK, Muller M, et al. Effect of neurological dysfunction on health-related quality of life in patients with high-grade glioma. J Neurooncol. 1997;34:263–78.

    Article  PubMed  CAS  Google Scholar 

  47. Giovagnoli AR, Silvani A, Colombo E, et al. Facets and determinants of quality of life in patients with recurrent high grade glioma. J Neurol Neurosurg Psychiatry. 2005;76:562–8.

    Article  PubMed  CAS  Google Scholar 

  48. Gupta D, Lis CG, Grutsch JF. The relationship between cancer-related fatigue and patient satisfaction with quality of life in cancer. J Pain Symptom Manage. 2007;34:40–7.

    Article  PubMed  Google Scholar 

  49. Pelletier G, Verhoef MJ, Khatri N, et al. Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues. J Neurooncol. 2002;57:41–9.

    Article  PubMed  Google Scholar 

  50. Mainio A, Tuunanen S, Hakko H, et al. Decreased quality of life and depression as predictors for shorter survival among patients with low-grade gliomas: a follow-up from 1990–2003. Eur Arch Psychiatry Clin Neurosci. 2006;256:516–21.

    Article  PubMed  Google Scholar 

  51. Bosma I, Reijneveld JC, Douw L, et al. Health-related quality of life of long-term high-grade glioma survivors. Neuro Oncol. 2009;11:51–8.

    Article  PubMed  Google Scholar 

  52. Kiebert GM, Curran D, Aaronson NK, et al. Quality of life after radiation therapy of cerebral low-grade gliomas of the adult: results of a randomised phase III trial on dose response (EORTC trial 22844). Eur J Cancer. 1998;34:1902–9.

    Article  PubMed  CAS  Google Scholar 

  53. Chang EF, Potts MB, Keles GE, et al. Seizure characteristics and control following resection in 332 patients with low-grade gliomas. J Neurosurg. 2008;108:227–35.

    Article  PubMed  Google Scholar 

  54. Duffau H. Lessons from brain mapping in surgery for low-grade glioma: insights into associations between tumour and brain plasticity. Lancet Neurol. 2005;2005(4):476–86.

    Article  Google Scholar 

  55. Sanai N, Mirzadeh Z, Berger MS. Functional outcome after language mapping for glioma resection. N Engl J Med. 2008;358:18–27.

    Article  PubMed  CAS  Google Scholar 

  56. Hayhurst C, Mendelsohn D, Bernstein M. Low grade glioma: a qualitative study of the wait and see approach. Can J Neurol Sci. 2011;38:256–61.

    PubMed  Google Scholar 

  57. Van den Bent MJ, Afra D, de Witte O, et al. Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet. 2005;366:985–90.

    Article  PubMed  Google Scholar 

  58. Liu R, Solheim K, Polley MY. Quality of life in low-grade glioma patients receiving temozolomide. Neuro Oncol. 2009;11:59–68.

    Article  PubMed  CAS  Google Scholar 

  59. Musat E, Roelofs E, Bar-Deroma R, et al. Dummy run and conformity indices in the ongoing EORTC low-grade glioma trial 22033–26033: first evaluation of quality of radiotherapy planning. Radiother Oncol. 2010;95:218–24.

    Article  PubMed  Google Scholar 

  60. Brown PD, Ballman KV, Rummans TA, et al. Prospective study of quality of life in adults with newly diagnosed high-grade gliomas. J Neurooncol. 2006;76:283–91.

    Article  PubMed  Google Scholar 

  61. Mauer M, Stupp R, Taphoorn MJ, et al. The prognostic value of health-related quality-of-life data in predicting survival in glioblastoma cancer patients: results from an international randomised phase III EORTC Brain Tumour and Radiation Oncology Groups, and NCIC Clinical Trials Group study. Br J Cancer. 2007;97:302–7.

    Article  PubMed  CAS  Google Scholar 

  62. Mauer ME, Taphoorn MJ, Bottomley A, et al. Prognostic value of health-related quality-of-life data in predicting survival in patients with anaplastic oligodendrogliomas, from a phase III EORTC brain cancer group study. J Clin Oncol. 2007;25:5731–7.

    Article  PubMed  Google Scholar 

  63. Velikova G, Awad N, Coles-Gale R, et al. The clinical value of quality of life assessment in oncology practice-a qualitative study of patient and physician views. Psychooncology. 2008;17:690–8.

    Article  PubMed  Google Scholar 

  64. Verdonck-de Leeuw IM, de Bree R, Keizer AL, Houffelaar T, Cuijpers P, van der Linden MH, Leemans CR. Computerized prospective screening for high levels of emotional distress in head and neck cancer patients and referral rate to psychosocial care. Oral Oncol. 2009;45:129–33.

    Article  Google Scholar 

  65. Sikkes SA, Visser PJ, Knol DL, et al. Do instrumental activities of daily living predict dementia at 1- and 2-year follow-up? Findings from the development of screening guidelines and diagnostic criteria for predementia Alzheimers’s disease study. J Am Geriatr Soc. 2011;59:2273–81.

    Article  PubMed  Google Scholar 

  66. Petersen MA, Groenvold M, Aaronson NK, et al. Development of computerised adaptive testing (CAT) for the EORTC QLQ-C30 dimensions. General approach and initial results for physical functioning. Eur J Cancer. 2010;46:1352–8.

    Article  PubMed  Google Scholar 

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Correspondence to Martin J. B. Taphoorn MD, PhD .

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Taphoorn, M.J.B. (2013). Quality of Life in Low-Grade Gliomas. In: Duffau, H. (eds) Diffuse Low-Grade Gliomas in Adults. Springer, London. https://doi.org/10.1007/978-1-4471-2213-5_14

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  • DOI: https://doi.org/10.1007/978-1-4471-2213-5_14

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