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Lee JA, Kim AR, Tak EY, Kim Y, Shin HJ, Mun GW, Kim SJ, Seol HJ. A single-center prospective study regarding time to return to activities of daily living after craniotomy for brain tumors. Acta Neurochir (Wien) 2023; 165:1389-1400. [PMID: 36977865 PMCID: PMC10047470 DOI: 10.1007/s00701-023-05533-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/15/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND There are few studies on the time to return to activities of daily living (ADL) after craniotomy in patients with brain tumors. This study aimed to investigate the duration before returning to ADLs after craniotomy for brain tumors and present data that can provide information and guidelines on the appropriate time needed. METHODS Patients (n = 183 of 234) who underwent craniotomy for brain tumors between April 2021 and July 2021 capable of self-care upon discharge were enrolled, and data of 158 were collected. The start time of 85 ADL items was prospectively investigated for 4 months postoperatively, using the self-recording sheet. RESULTS Over 89% and 87% of the patients performed basic ADL items within a month and instrumental ADL items within 2 months (medians: within 18 days), except for a few. Regarding work, 50% of the patients returned within 4 months. Washing hair with a wound was performed at 18 days of median value, after 4 months of dyeing/perming hair, 6 days of drinking coffee/tea, after 4 months of air travel, and 40 days of complementary and alternative medicine. In patients with infratentorial tumors or surgical problems, return times were much later for various items. CONCLUSIONS It is possible to provide practical information and guidelines on the duration to return to ADL after craniotomy in brain tumor patients. These study findings also reduce uncertainty about recovery and daily life and help patients return to their daily life at the appropriate time, thereby maintaining function and daily well-being after surgery.
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Affiliation(s)
- Jeong-A Lee
- Department of Nursing, Samsung Medical Center, Seoul, Korea
| | - Ae Ran Kim
- Department of Nursing, Samsung Medical Center, Seoul, Korea
| | - Eun-Young Tak
- Department of Nursing, Samsung Medical Center, Seoul, Korea
| | - Yumin Kim
- Department of Nursing, Samsung Medical Center, Seoul, Korea
| | - Hyun-Ju Shin
- Department of Nursing, Samsung Medical Center, Seoul, Korea
| | - Gyeong-Won Mun
- Department of Nursing, Samsung Medical Center, Seoul, Korea
| | - Sook-Jin Kim
- Department of Nursing, Samsung Medical Center, Seoul, Korea
| | - Ho Jun Seol
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-Gu, Seoul, 06351, Korea.
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2
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Mercieca-Bebber R, Aiyegbusi OL, King MT, Brundage M, Snyder C, Calvert M. Knowledge translation concerns for the CONSORT-PRO extension reporting guidance: a review of reviews. Qual Life Res 2022; 31:2939-2957. [PMID: 35347521 PMCID: PMC9470606 DOI: 10.1007/s11136-022-03119-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 10/29/2022]
Abstract
This review of reviews aimed to appraise the use of the CONSORT-PRO Extension as an evaluation tool for assessing the reporting of patient-reported outcome (PROs) in publications, and to describe the reporting of PRO research across reviews. We also outlined how variation in such evaluations impacts knowledge translation and may lead to potential misuse of the CONSORT-PRO Extension. We systematically searched Medline, Pubmed and CINAHL from 2013 to 2025 March 2021 for reviews of the completeness of reporting of PRO endpoints according to CONSORT-PRO criteria. Two reviewers extracted details of each review, the percentage of included studies that addressed each CONSORT-PRO item, and key recommendations from each review. Fourteen reviews met inclusion criteria, and only six of these used the full CONSORT-PRO checklist with minimal justified modifications. The remaining eight studies made significant or unjustified adjustments to the CONSORT-PRO Extension. Review studies also varied in how they scored multi-component CONSORT-PRO items. CONSORT-PRO items were often unreported in trial reports, and certain CONSORT-PRO items were reported less often than others. The reporting of statistical approaches to dealing with missing PRO data were poor in RCTs included in all 14 review articles. Studies reviewing PRO publications often omitted recommended CONSORT-PRO items from their evaluations, which may cause confusion among readers regarding how best to report their PRO research according to the CONSORT-PRO extension. Many trials published since CONSORT-PRO's release did not report recommended CONSORT-PRO items, which may lead to misinterpretation and consequently to research waste.
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Affiliation(s)
- Rebecca Mercieca-Bebber
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research, and Birmingham Health Partners Centre for Regulatory Science and Innovation, Institute of Applied Health Research, University of Birmingham, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Research Centre, NIHR Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
| | - Madeleine T King
- School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
| | - Michael Brundage
- Cancer Care and Epidemiology, Department of Oncology, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Claire Snyder
- Johns Hopkins School of Medicine and Bloomberg School of Public Health, Baltimore, MD, USA
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research, and Birmingham Health Partners Centre for Regulatory Science and Innovation, Institute of Applied Health Research, University of Birmingham, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
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3
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Toward the Next Generation of High-Grade Glioma Clinical Trials in the Era of Precision Medicine. Cancer J 2021; 27:410-415. [PMID: 34570456 DOI: 10.1097/ppo.0000000000000549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
ABSTRACT In the era of precision medicine, there is a desire to harness our improved understanding of genomic and molecular underpinnings of gliomas to develop therapies that can be tailored to individual patients and tumors. With the rapid development of novel therapies, there has been a growing need to develop smart clinical trials that are designed to efficiently test promising agents, identify therapies likely to benefit patients, and discard ineffective therapies. We review clinical trial design in gliomas and developments designed to address the unique challenges of precision medicine. To provide an overview of this topic, we examine considerations for endpoints and response assessment, biomarkers, and novel clinical trial designs such as adaptive platform trials in the testing of new therapies for glioma patients.
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4
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Coomans MB, Peeters MC, Koekkoek JA, Schoones JW, Reijneveld J, Taphoorn MJ, Dirven L. Research Objectives, Statistical Analyses and Interpretation of Health-Related Quality of Life Data in Glioma Research: A Systematic Review. Cancers (Basel) 2020; 12:E3502. [PMID: 33255505 PMCID: PMC7760401 DOI: 10.3390/cancers12123502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) has become an increasingly important patient-reported outcome in glioma studies. Ideally, collected HRQoL data should be exploited to the full, with proper analytical methods. This systematic review aimed to provide an overview on how HRQoL data is currently evaluated in glioma studies, focusing on the research objectives and statistical analyses of HRQoL data. METHODS A systematic literature search in the databases PubMed, Embase, Web of Science and Cochrane was conducted up to 5 June 2020. Articles were selected based on predetermined inclusion criteria and information on study design, HRQoL instrument, HRQoL research objective and statistical methods were extracted. RESULTS A total of 170 articles describing 154 unique studies were eligible, in which 17 different HRQoL instruments were used. HRQoL was the primary outcome in 62% of the included articles, and 51% investigated ≥1 research question with respect to HRQoL, for which various analytical methods were used. In only 42% of the articles analyzing HRQoL results over time, the minimally clinical important difference was reported and interpreted. Eighty-six percent of articles reported HRQoL results at a group level only, and not at the individual patient level. CONCLUSION Currently, the assessment and analysis of HRQoL outcomes in glioma studies is highly variable. Opportunities to maximize information obtained with HRQoL data include appropriate and complementary analyses at both the group and individual level, comprehensive reporting of HRQoL results in separate articles or supplementary material, and adherence to existing guidelines about the assessment, analysis and reporting of patient-reported outcomes.
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Affiliation(s)
- Marijke B. Coomans
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.C.M.P.); (J.A.F.K.); (M.J.B.T.); (L.D.)
| | - Marthe C.M. Peeters
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.C.M.P.); (J.A.F.K.); (M.J.B.T.); (L.D.)
| | - Johan A.F. Koekkoek
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.C.M.P.); (J.A.F.K.); (M.J.B.T.); (L.D.)
- Department of Neurology, Haaglanden Medical Center, 2262 BA The Hague, The Netherlands
| | - Jan W. Schoones
- Walaeus Library, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | - Jaap Reijneveld
- Department of Neurology and Brain Tumour Center Amsterdam, Amsterdam University Medical Center, 1007 MB Amsterdam, The Netherlands;
- Stichting Epilepsie Instellingen Nederland (SEIN), 2103 SW Heemstede, The Netherlands
| | - Martin J.B. Taphoorn
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.C.M.P.); (J.A.F.K.); (M.J.B.T.); (L.D.)
- Department of Neurology, Haaglanden Medical Center, 2262 BA The Hague, The Netherlands
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.C.M.P.); (J.A.F.K.); (M.J.B.T.); (L.D.)
- Department of Neurology, Haaglanden Medical Center, 2262 BA The Hague, The Netherlands
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5
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Gosselt IK, Scheepers VPM, Spreij LA, Visser-Meily JMA, Nijboer TCW. Cognitive complaints in brain tumor patients and their relatives' perspectives. Neurooncol Pract 2020; 8:160-170. [PMID: 33898049 DOI: 10.1093/nop/npaa078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Cognitive deficits have been frequently assessed in brain tumor patients. However, self-reported cognitive complaints have received little attention so far. Cognitive complaints are important as they often interfere with participation in society. In this study, cognitive complaints were systematically assessed in brain tumor patients. As patients' experiences and relatives' estimations may vary, the level of agreement was investigated. Methods Brain tumor outpatients (n = 47) and relatives (n = 42) completed the inventory Cognitive Complaints-Participation, assessing cognitive complaints across 10 daily life activities and cognitive domains (total, memory, executive, attention). Cognitive complaints scores were compared between patients with different clinical characteristics (tumor type, number of treatments, the absence/presence of epilepsy). Complaints difference scores in patient-relative pairs were calculated to explore the level of agreement using intraclass correlations (ICC). Furthermore, we explored whether the level of agreement was related to (1) the magnitude of cognitive complaints in patient-relative pairs and (2) patients' cognitive functioning (assessed with the Montreal Cognitive Assessment). Results Patients and relatives reported most cognitive complaints during work/education (100%) and social contacts (88.1%). Patients with different clinical characteristics reported comparable cognitive complaints scores. Overall, the level of agreement in patient-relative pairs was moderate-good (ICC 0.73-0.86). Although in 24% of the pairs, there was a substantial disagreement. The level of agreement was not related to the magnitude of complaints in patient-relative pairs or patients' cognitive functioning. Conclusion Both the perspectives of brain tumor patients and their relatives' on cognitive complaints are important. Clinicians could encourage communication to reach mutual understanding.
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Affiliation(s)
- Isabel K Gosselt
- Center of Excellence for Rehabilitation Medicine Utrecht, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Vera P M Scheepers
- Center of Excellence for Rehabilitation Medicine Utrecht, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lauriane A Spreij
- Center of Excellence for Rehabilitation Medicine Utrecht, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine Utrecht, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tanja C W Nijboer
- Center of Excellence for Rehabilitation Medicine Utrecht, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
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6
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Peeters MC, Zwinkels H, Koekkoek JA, Vos MJ, Dirven L, Taphoorn MJ. The Impact of the Timing of Health-Related Quality of Life Assessments on the Actual Results in Glioma Patients: A Randomized Prospective Study. Cancers (Basel) 2020; 12:cancers12082172. [PMID: 32764261 PMCID: PMC7465107 DOI: 10.3390/cancers12082172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 11/21/2022] Open
Abstract
Background: The aim of this study was to explore the impact of the timing of Health-Related Quality of Life (HRQoL) measurements in clinical care on the obtained HRQoL scores in glioma patients, and the association with feelings of anxiety or depression. Methods: Patients completed the European Organisation for Research and Treatment of Cancer (EORTC)’s Quality of Life Questionnaires (QLQ-C30 and QLQ-BN20), and the Hospital Anxiety and Depression Scale (HADS) twice. All patients completed the first measurement on the day of the Magnetic Resonance Imaging (MRI) scan (t = 0), but the second measurement (t = 1) depended on randomization; Group 1 (n = 49) completed the questionnaires before and Group 2 (n = 51) after the consultation with the physician. Results: median HRQoL scale scores on t0/t1 and change scores were comparable between the two groups. Between 8–58% of patients changed to a clinically relevant extent (i.e., ≥10 points) on the evaluated HRQoL scales in about one-week time, in both directions, with only 3% of patients remaining stable in all scales. Patients with a stable role functioning had a lower HADS anxiety change score. The HADS depression score was not associated with a change in HRQoL. Conclusions: Measuring HRQoL before or after the consultation did not impact HRQoL scores on a group level. However, most patients reported a clinically relevant difference in at least one HRQoL scale between the two time points. These findings highlight the importance of standardized moments of HRQoL assessments, or patient-reported outcomes in general, during treatment and follow-up in clinical trials.
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Affiliation(s)
- Marthe C.M. Peeters
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (J.A.F.K.); (L.D.); (M.J.B.T.)
- Correspondence: ; Tel.: +31-071-526-2547
| | - Hanneke Zwinkels
- Department of Neurology, Haaglanden Medical Center, 2262 BA The Hague, The Netherlands; (H.Z.); (M.J.V.)
| | - Johan A.F. Koekkoek
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (J.A.F.K.); (L.D.); (M.J.B.T.)
- Department of Neurology, Haaglanden Medical Center, 2262 BA The Hague, The Netherlands; (H.Z.); (M.J.V.)
| | - Maaike J. Vos
- Department of Neurology, Haaglanden Medical Center, 2262 BA The Hague, The Netherlands; (H.Z.); (M.J.V.)
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (J.A.F.K.); (L.D.); (M.J.B.T.)
- Department of Neurology, Haaglanden Medical Center, 2262 BA The Hague, The Netherlands; (H.Z.); (M.J.V.)
| | - Martin J.B. Taphoorn
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (J.A.F.K.); (L.D.); (M.J.B.T.)
- Department of Neurology, Haaglanden Medical Center, 2262 BA The Hague, The Netherlands; (H.Z.); (M.J.V.)
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7
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Oort Q, Taphoorn MJB, Sikkes SAM, Uitdehaag BMJ, Reijneveld JC, Dirven L. Evaluation of the content coverage of questionnaires containing basic and instrumental activities of daily living (ADL) used in adult patients with brain tumors. J Neurooncol 2019; 143:1-13. [PMID: 30887244 PMCID: PMC6482128 DOI: 10.1007/s11060-019-03136-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 02/26/2019] [Indexed: 11/15/2022]
Abstract
Background Everyday functioning can be assessed using measures of basic activities of daily living (BADL) or instrumental activities of daily living (IADL). The aim of this review was to provide an overview of the scope and specific content of BADL and/or IADL covered by currently used questionnaires in adult brain tumor patient studies. Methods Electronic databases were searched up to April 2017 to identify all eligible questionnaires with items regarding BADL/IADL in studies with adult brain tumor patients. Articles were selected using predetermined in- and exclusion criteria. Items with similar content were clustered into domains based on type of activity. Results Thirty-one unique questionnaires containing at least one BADL and/or IADL item were identified; 21 and 29 questionnaires containing ≥ 1 BADL or IADL item, respectively. The percentage of ADL items in these questionnaires ranged from 4 to 100%. Only two questionnaires were specifically developed to measure BADL (Barthel Index and Katz-ADL) and two specifically for IADL (Lawton-Brody IADL and preliminary IADL-BN). Content clustering revealed that IADL had a larger variation in content (31 domains, e.g. work or leisure time activities) compared to BADL (15 domains, e.g. mobility or bathing/washing). Conclusion Thirty-one questionnaires previously used in brain tumor studies contained items on BADL and/or IADL and covered a wide range of content, in particular for IADL. It is currently unclear which BADL/IADL are most relevant for brain tumor patients, and this should therefore be evaluated. Next, existing questionnaires could be adapted or validated, or new measures can be developed to meet these needs. Electronic supplementary material The online version of this article (10.1007/s11060-019-03136-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Quirien Oort
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam University Medical Centers (Location VUmc), PO BOX 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Sietske A M Sikkes
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers (Location VUmc), Amsterdam, The Netherlands.,Alzheimer Center, Amsterdam University Medical Centers (Location VUmc), Amsterdam, The Netherlands
| | - Bernard M J Uitdehaag
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam University Medical Centers (Location VUmc), PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
| | - Jaap C Reijneveld
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam University Medical Centers (Location VUmc), PO BOX 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Neurology, Amsterdam University Medical Centers (Location AMC), Amsterdam, The Netherlands
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
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Renovanz M, Maurer D, Lahr H, Weimann E, Deininger M, Wirtz CR, Ringel F, Singer S, Coburger J. Supportive Care Needs in Glioma Patients and Their Caregivers in Clinical Practice: Results of a Multicenter Cross-Sectional Study. Front Neurol 2018; 9:763. [PMID: 30254605 PMCID: PMC6141995 DOI: 10.3389/fneur.2018.00763] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 08/22/2018] [Indexed: 12/21/2022] Open
Abstract
Objective: Supportive care needs in glioma patients often remain unrecognized, and optimization in assessment is required. First, we aimed at assessing the support needed using a simple structured questionnaire. Second, we investigated the psychosocial burden and support requested from caregivers. Methods: Patients were assessed at three centers during their outpatient visits. They completed the Distress Thermometer (DT; score ≥ 6 indicated significant burden in brain tumor patients), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30+BN20, and the Patients' Perspective Questionnaire (PPQ) that assessed psychosocial distress as well as support requested and received by patients for specific domains (e.g., family, doctor, and mobile care). In each subgroup, patients' caregivers were assessed simultaneously by a questionnaire developed for the study. Multivariate backward logistic regressions were performed for investigating predictors of patients' request for support. Results: Assessments were conducted for 232 patients. Most patients (82%) had a high-grade glioma and a mean age of 52 years (range 20-87). The male to female ratio was 1.25:1. According to the PPQ results, 38% (87) of the patients felt depressed; 44% (103), anxious; and 39% (91), tense/nervous. Desired support was highest from doctors (59%) and psychologists (19%). A general request for support was associated with lower global health status (p = 0.03, odds ratio (OR) = 0.96, 95% CI: 0.92-0.99) according to EORTC QLQ-C30. Most of the assessed caregivers (n = 96) were life partners (64%; n = 61) who experienced higher distress than the corresponding patients (caregivers: 6.5 ± 2.5 vs. patients: 5.3 ± 2.4). When patients were on chemotherapy, caregivers indicated DT ≥ 6 significantly more frequently than patients themselves (p = 0.02). Conclusion: Our data showed that glioma patients and their caregivers were both highly burdened. The PPQ allowed us to evaluate the psychosocial support requested and perceived by patients, detect supportive care needs, and provide information at a glance. Patients in poorer clinical condition are at risk of having unmet needs. The caregivers' burden and unmet needs are not congruent with the patients' need for support. In particular, caregivers of patients on chemotherapy were more highly burdened than patients themselves.
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Affiliation(s)
- Mirjam Renovanz
- Department of Neurosurgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Dorothea Maurer
- Department of Neurosurgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Heike Lahr
- Department of Neurosurgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Elke Weimann
- Department of Neurology, Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Monika Deininger
- Department of Neurosurgery, University Medical Center Ulm, Günzburg, Germany
| | | | - Florian Ringel
- Department of Neurosurgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jan Coburger
- Department of Neurosurgery, University Medical Center Ulm, Günzburg, Germany
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9
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Psychiatric co-morbidity, distress, and use of psycho-social services in adult glioma patients-a prospective study. Acta Neurochir (Wien) 2018; 160:1187-1194. [PMID: 29594548 DOI: 10.1007/s00701-018-3527-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 03/22/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Distress impacts the daily life of glioma patients. This study explored its course over time and the usage of psychosocial care. METHODS A consecutive sample of glioma patients completed the Hospital Anxiety and Depression Scale to assess distress levels at admission to the hospital (t1), before discharge (t2), after 3 months (t3), and after 6 months (t4). They were interviewed with the Structured Clinical Interview for DSM-IV to ascertain psychiatric disorders at t2. Psycho-oncological care in the hospital was determined with the Hospital Information System, and the use of outpatient treatment was evaluated with the Health Care Usage Questionnaire at t4. We compared the percentages of elevated distress, psychiatric co-morbidity, and care usage between men and women. RESULTS During the study period, 37 patients were enrolled. Nineteen percent of the patients were diagnosed with a psychiatric disorder. The percentages of patients with elevated distress were 56, 59, 39, and 40% at t1, t2, t3, and t4, respectively. Participants who did not survive the 6 months presented with higher levels of distress. In the hospital, 14% of those with elevated distress were visited by a psycho-oncologist. In the outpatient setting, 43% of those with elevated distress visited a neuro-psychiatrist, and 14% went to a psychotherapist. There was no evidence for an effect of gender on psychiatric co-morbidity, distress, or care use. CONCLUSIONS A significant proportion of glioma patients report elevated distress during the hospital stay and thereafter. Only a fraction of them receive mental health care.
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10
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Health-Related Quality of Life and Cancer-Related Symptoms During Interdisciplinary Outpatient Rehabilitation for Malignant Brain Tumor. Am J Phys Med Rehabil 2017; 96:852-860. [PMID: 28441148 DOI: 10.1097/phm.0000000000000756] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of the study was to determine the relationships between functional outcomes, clinical symptoms, and health-related quality of life among patients with malignant brain tumors receiving interdisciplinary outpatient rehabilitation. DESIGN A prospective study of 49 adults with malignant brain tumors participating in outpatient therapies was performed. Outcome measures included the Functional Assessment of Cancer Therapy-Brain (FACT-Br) for health-related quality of life and the Patient-Reported Outcome Measures Instrument Survey (PROMIS) Depression and Pain Behavior scales measured at admission, discharge, 1 and 3 mos after discharge. Day Rehabilitation Outcome Scale (DayROS), a functional measure, was measured at admission and discharge. RESULTS The FACT-Br scores, PROMIS pain, and PROMIS depression scores did not significantly change. There were many negative associations seen between FACT-Br and PROMIS depression (all P < .0001) and less associations with PROMIS pain. There was a positive correlation between Day Rehabilitation Outcome Scale and FACT-Br (P = .0058) and a negative association with PROMIS pain (P = .028), but not with PROMIS depression. There were no correlations between Day Rehabilitation Outcome Scale gains and change in PROMIS depression, FACT-Br total, or PROMIS pain. CONCLUSIONS Health-related quality of life, pain, and depression did not worsen. Patients who reported less depression and pain had better reported health-related quality of life. Level of function was also associated with HRQOL and pain, but not depression.
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11
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Taylor JW, Molinaro AM, Butowski N, Prados M. Clinical trial endpoints for patients with gliomas. Neurooncol Pract 2017; 4:201-208. [PMID: 31385993 PMCID: PMC6655446 DOI: 10.1093/nop/npw034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Malignant glioma represents a diverse set of molecularly heterogeneous diseases. Few therapeutic agents have been approved despite decades of clinical trials research and pre-clinical investigation. Attempts to refine neuroimaging criteria and recent discovery of the genomic profiles linking tumor subsets to survival outcomes have spurred discussion on a variety of new approaches in clinical trial design and relevant endpoints. Here we focus on those endpoints in clinical trial design for patients with primary glioma and related issues still to be resolved.
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Affiliation(s)
- Jennie W Taylor
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California (J.W.T., A.M.M., N.B., M.P.)
- Department of Neurology, University of California San Francisco, San Francisco, California (J.W.T.)
| | - Annette M Molinaro
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California (J.W.T., A.M.M., N.B., M.P.)
- Department of Epidemiology & Biostatistics, University of California at San Francisco, San Francisco, California (A.M.M.)
| | - Nicholas Butowski
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California (J.W.T., A.M.M., N.B., M.P.)
| | - Michael Prados
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California (J.W.T., A.M.M., N.B., M.P.)
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12
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Renovanz M, Hechtner M, Kohlmann K, Janko M, Nadji-Ohl M, Singer S, Ringel F, Coburger J, Hickmann AK. Compliance with patient-reported outcome assessment in glioma patients: predictors for drop out. Neurooncol Pract 2017; 5:129-138. [PMID: 31385978 DOI: 10.1093/nop/npx026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Patient-reported outcomes are of high importance in clinical neuro-oncology. However, assessment is still suboptimal. We aimed at exploring factors associated with the probability for a) drop out of study and b) death during follow-up. Methods Patients were assessed twice during follow-up visits scheduled within 3 to 5 months of each other by using 3 validated patient-reported outcome measures (t1: first assessment, t2: second assessment). As "death" was seen as a competing risk for drop out, univariate competing risk Cox regression models were applied to explore factors associated with dropping out (age, gender, WHO grade, living situation, recurrent surgery, Karnofsky Performance Status, time since diagnosis, and patient-reported outcomes assessed by Distress Thermometer, EORTC-QLQ-C30, EORTC-QLQ-BN20, and SCNS-SF-34G). Results Two hundred forty-six patients were eligible, 173 (70%) participated. Patients declining participation were diagnosed with glioblastomas more often than with other gliomas (56% vs 39%). At t2, 32 (18%) patients dropped out, n = 14 death-related, n = 18 for other reasons. Motor dysfunction (EORTC-QLQ-BN20) was associated with higher risk for non-death-related drop out (HR: 1.02; 95% CI, 1.00-1.03; P = .03). Death-related drop out was associated with age (HR: 1.09; 95% CI, 1.03-1.14; P = .002), Karnofsky Performance Status (HR: 0.92; 95% CI, 0.88-0.96; P < .001), lower physical functioning (EORTC-QLQ-C30; HR: 0.98; 95% CI, 0.96-1.00; P = .04) and lower motor functioning (EORTC-QLQ-BN20; HR: 1.020; 95% CI, 1.00-1.04; P = .02). Conclusion Patients with motor dysfunction and poorer clinical condition seem to be more likely to drop out of studies applying patient-reported outcome measures. This should be taken into account when planning studies assessing glioma patients and for interpretation of results of patient-reported outcome assessments in clinical routine.
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Affiliation(s)
- Mirjam Renovanz
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Marlene Hechtner
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Karoline Kohlmann
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Mareile Janko
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Minou Nadji-Ohl
- Department of Neurosurgery Klinikum Stuttgart, Katharinenhospital, Stuttgart Germany
| | - Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz Germany
| | - Jan Coburger
- Department of Neurosurgery, University Medical Center Ulm/Günzburg, Günzburg Germany
| | - Anne-Katrin Hickmann
- Department of Neurosurgery Klinikum Stuttgart, Katharinenhospital, Stuttgart Germany.,Department of Neurosurgery Hirslanden Klinikum, Luzern Switzerland
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13
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Oort Q, Dirven L, Meijer W, Sikkes SAM, Uitdehaag BMJ, Reijneveld JC, Taphoorn MJB. Development of a questionnaire measuring instrumental activities of daily living (IADL) in patients with brain tumors: a pilot study. J Neurooncol 2017; 132:145-153. [PMID: 28150189 PMCID: PMC5352794 DOI: 10.1007/s11060-016-2352-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 12/23/2016] [Indexed: 12/04/2022]
Abstract
Both dementia and brain tumor patients exhibit cognitive decline during the course of their disease. They might therefore experience similar problems with cognitively complex daily activities (i.e., instrumental activities of daily living (IADL)). The study's objective is to evaluate if the Amsterdam IADL Questionnaire© (A-IADL-Q), a 70-item IADL questionnaire developed for and validated in early dementia patients, is also applicable to glioma patients. The evaluation consisted of three steps. Predetermined decision rules defined which activities were retained, altered, added or excluded. In the first step, 6 neuro-oncology health care professionals (HCP) and 10 glioma patient-proxy dyads were asked to evaluate the 70 A-IADL-Q activities. In the second step, in-depth interviews were conducted with 6 HCPs and 6 other patient-proxy dyads to generate relevant activities specific to glioma patients not covered by the A-IADL-Q. In the third step, 6 new patient-proxy dyads were cognitively debriefed with the list of activities constructed in the previous steps. Results indicated that in step 1, after alterations and exclusions, 28/70 activities could be retained. Nine newly generated activities were subsequently added in step 2. In step 3, the 37 activities were presented to the patient-proxy dyads. Based on their input, several additional alterations and exclusions were made resulting in a list of 32 activities. In conclusion, this evaluation of the A-IADL-Q showed that dementia-specific IADL activities are only partly applicable to glioma patients, and that the addition of glioma specific IADL activities is necessary to capture the IADL construct. This underlines the need for a disease-specific IADL questionnaire for brain tumor patients.
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Affiliation(s)
- Q Oort
- Department of Neurology and Brain Tumor Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - L Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - W Meijer
- Department of Neurology and Brain Tumor Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - S A M Sikkes
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.,Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - B M J Uitdehaag
- Department of Neurology and Brain Tumor Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - J C Reijneveld
- Department of Neurology and Brain Tumor Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
| | - M J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
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14
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Calvert M, Kyte D, Duffy H, Gheorghe A, Mercieca-Bebber R, Ives J, Draper H, Brundage M, Blazeby J, King M. Patient-reported outcome (PRO) assessment in clinical trials: a systematic review of guidance for trial protocol writers. PLoS One 2014; 9:e110216. [PMID: 25333995 PMCID: PMC4198295 DOI: 10.1371/journal.pone.0110216] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 09/10/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Evidence suggests there are inconsistencies in patient-reported outcome (PRO) assessment and reporting in clinical trials, which may limit the use of these data to inform patient care. For trials with a PRO endpoint, routine inclusion of key PRO information in the protocol may help improve trial conduct and the reporting and appraisal of PRO results; however, it is currently unclear exactly what PRO-specific information should be included. The aim of this review was to summarize the current PRO-specific guidance for clinical trial protocol developers. METHODS AND FINDINGS We searched the MEDLINE, EMBASE, CINHAL and Cochrane Library databases (inception to February 2013) for PRO-specific guidance regarding trial protocol development. Further guidance documents were identified via Google, Google scholar, requests to members of the UK Clinical Research Collaboration registered clinical trials units and international experts. Two independent investigators undertook title/abstract screening, full text review and data extraction, with a third involved in the event of disagreement. 21,175 citations were screened and 54 met the inclusion criteria. Guidance documents were difficult to access: electronic database searches identified just 8 documents, with the remaining 46 sourced elsewhere (5 from citation tracking, 27 from hand searching, 7 from the grey literature review and 7 from experts). 162 unique PRO-specific protocol recommendations were extracted from included documents. A further 10 PRO recommendations were identified relating to supporting trial documentation. Only 5/162 (3%) recommendations appeared in ≥50% of guidance documents reviewed, indicating a lack of consistency. CONCLUSIONS PRO-specific protocol guidelines were difficult to access, lacked consistency and may be challenging to implement in practice. There is a need to develop easily accessible consensus-driven PRO protocol guidance. Guidance should be aimed at ensuring key PRO information is routinely included in appropriate trial protocols, in order to facilitate rigorous collection/reporting of PRO data, to effectively inform patient care.
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Affiliation(s)
- Melanie Calvert
- Primary Care and Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
- MRC Midland Hub for Trials Methodology Research, Birmingham, United Kingdom
| | - Derek Kyte
- Primary Care and Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
- School of Sport, Exercise & Rehabilitation, University of Birmingham, Birmingham, United Kingdom
| | - Helen Duffy
- Primary Care and Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Adrian Gheorghe
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Jonathan Ives
- Medicine. Ethics, Society and History, University of Birmingham, Birmingham, United Kingdom
| | - Heather Draper
- MRC Midland Hub for Trials Methodology Research, Birmingham, United Kingdom
- Medicine. Ethics, Society and History, University of Birmingham, Birmingham, United Kingdom
| | | | - Jane Blazeby
- MRC ConDuCT II Hub for Trials Methodology Research, School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Madeleine King
- Psycho-oncology Co-operative Research Group, University of Sydney, Sydney, Australia
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15
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Lwin Z, Broom A, Cosman R, Livingstone A, Sawkins K, Good P, Kirby E, Koh ES, Hovey E. Culturally and linguistically diverse patient participation in glioma research. Neurooncol Pract 2014; 1:101-105. [PMID: 26034622 DOI: 10.1093/nop/npu009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Indexed: 11/14/2022] Open
Abstract
Marginal communities, such as culturally and linguistically diverse (CALD) patients, have significantly lower rates of recruitment, accrual, and retention in cancer clinical trials. A combination of language and cultural barriers means that trial participation from CALD communities remains at suboptimal levels, which in turn favors research findings that are biased towards therapeutic effects or toxicities within the context of non-CALD populations. Here we outline some key challenges and implications for CALD patient participation in glioma research in countries such as Australia, where English is the language of governance and health services implementation. We highlight multistakeholder interventions to improve both investigator recruitment and participation of CALD communities in future glioma research, particularly in this era when global migration has come of age. Enhancing research participation of CALD communities ensures not only wider understanding of genetic heterogeneity to improve glioma outcomes but also equity in access to care.
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Affiliation(s)
- Zarnie Lwin
- Department of Medical Oncology , Royal Brisbane and Women's Hospital, Brisbane, Australia (Z.L.); School of Social Science , University of Queensland, St. Lucia, Australia (A.B., E.K.); Cooperative Trials Group for Neuro-Oncology (COGNO) and NHMRC Clinical Trials Centre , University of Sydney, Sydney, Australia (R.C., A.L., K.S.,); Department of Palliative Care , Mater Health Services, South Brisbane, Australia (P.G.); Department of Radiation Oncology , Liverpool Hospital, Liverpool, Australia (E.-S.K.); University of New South Wales, Sydney, Australia (E.-S.K., E.H.); Department of Medical Oncology , Prince of Wales Hospital , Sydney, Australia (E.H.)
| | - Alexander Broom
- Department of Medical Oncology , Royal Brisbane and Women's Hospital, Brisbane, Australia (Z.L.); School of Social Science , University of Queensland, St. Lucia, Australia (A.B., E.K.); Cooperative Trials Group for Neuro-Oncology (COGNO) and NHMRC Clinical Trials Centre , University of Sydney, Sydney, Australia (R.C., A.L., K.S.,); Department of Palliative Care , Mater Health Services, South Brisbane, Australia (P.G.); Department of Radiation Oncology , Liverpool Hospital, Liverpool, Australia (E.-S.K.); University of New South Wales, Sydney, Australia (E.-S.K., E.H.); Department of Medical Oncology , Prince of Wales Hospital , Sydney, Australia (E.H.)
| | - Rasha Cosman
- Department of Medical Oncology , Royal Brisbane and Women's Hospital, Brisbane, Australia (Z.L.); School of Social Science , University of Queensland, St. Lucia, Australia (A.B., E.K.); Cooperative Trials Group for Neuro-Oncology (COGNO) and NHMRC Clinical Trials Centre , University of Sydney, Sydney, Australia (R.C., A.L., K.S.,); Department of Palliative Care , Mater Health Services, South Brisbane, Australia (P.G.); Department of Radiation Oncology , Liverpool Hospital, Liverpool, Australia (E.-S.K.); University of New South Wales, Sydney, Australia (E.-S.K., E.H.); Department of Medical Oncology , Prince of Wales Hospital , Sydney, Australia (E.H.)
| | - Ann Livingstone
- Department of Medical Oncology , Royal Brisbane and Women's Hospital, Brisbane, Australia (Z.L.); School of Social Science , University of Queensland, St. Lucia, Australia (A.B., E.K.); Cooperative Trials Group for Neuro-Oncology (COGNO) and NHMRC Clinical Trials Centre , University of Sydney, Sydney, Australia (R.C., A.L., K.S.,); Department of Palliative Care , Mater Health Services, South Brisbane, Australia (P.G.); Department of Radiation Oncology , Liverpool Hospital, Liverpool, Australia (E.-S.K.); University of New South Wales, Sydney, Australia (E.-S.K., E.H.); Department of Medical Oncology , Prince of Wales Hospital , Sydney, Australia (E.H.)
| | - Kate Sawkins
- Department of Medical Oncology , Royal Brisbane and Women's Hospital, Brisbane, Australia (Z.L.); School of Social Science , University of Queensland, St. Lucia, Australia (A.B., E.K.); Cooperative Trials Group for Neuro-Oncology (COGNO) and NHMRC Clinical Trials Centre , University of Sydney, Sydney, Australia (R.C., A.L., K.S.,); Department of Palliative Care , Mater Health Services, South Brisbane, Australia (P.G.); Department of Radiation Oncology , Liverpool Hospital, Liverpool, Australia (E.-S.K.); University of New South Wales, Sydney, Australia (E.-S.K., E.H.); Department of Medical Oncology , Prince of Wales Hospital , Sydney, Australia (E.H.)
| | - Phillip Good
- Department of Medical Oncology , Royal Brisbane and Women's Hospital, Brisbane, Australia (Z.L.); School of Social Science , University of Queensland, St. Lucia, Australia (A.B., E.K.); Cooperative Trials Group for Neuro-Oncology (COGNO) and NHMRC Clinical Trials Centre , University of Sydney, Sydney, Australia (R.C., A.L., K.S.,); Department of Palliative Care , Mater Health Services, South Brisbane, Australia (P.G.); Department of Radiation Oncology , Liverpool Hospital, Liverpool, Australia (E.-S.K.); University of New South Wales, Sydney, Australia (E.-S.K., E.H.); Department of Medical Oncology , Prince of Wales Hospital , Sydney, Australia (E.H.)
| | - Emma Kirby
- Department of Medical Oncology , Royal Brisbane and Women's Hospital, Brisbane, Australia (Z.L.); School of Social Science , University of Queensland, St. Lucia, Australia (A.B., E.K.); Cooperative Trials Group for Neuro-Oncology (COGNO) and NHMRC Clinical Trials Centre , University of Sydney, Sydney, Australia (R.C., A.L., K.S.,); Department of Palliative Care , Mater Health Services, South Brisbane, Australia (P.G.); Department of Radiation Oncology , Liverpool Hospital, Liverpool, Australia (E.-S.K.); University of New South Wales, Sydney, Australia (E.-S.K., E.H.); Department of Medical Oncology , Prince of Wales Hospital , Sydney, Australia (E.H.)
| | - Eng-Siew Koh
- Department of Medical Oncology , Royal Brisbane and Women's Hospital, Brisbane, Australia (Z.L.); School of Social Science , University of Queensland, St. Lucia, Australia (A.B., E.K.); Cooperative Trials Group for Neuro-Oncology (COGNO) and NHMRC Clinical Trials Centre , University of Sydney, Sydney, Australia (R.C., A.L., K.S.,); Department of Palliative Care , Mater Health Services, South Brisbane, Australia (P.G.); Department of Radiation Oncology , Liverpool Hospital, Liverpool, Australia (E.-S.K.); University of New South Wales, Sydney, Australia (E.-S.K., E.H.); Department of Medical Oncology , Prince of Wales Hospital , Sydney, Australia (E.H.)
| | - Elizabeth Hovey
- Department of Medical Oncology , Royal Brisbane and Women's Hospital, Brisbane, Australia (Z.L.); School of Social Science , University of Queensland, St. Lucia, Australia (A.B., E.K.); Cooperative Trials Group for Neuro-Oncology (COGNO) and NHMRC Clinical Trials Centre , University of Sydney, Sydney, Australia (R.C., A.L., K.S.,); Department of Palliative Care , Mater Health Services, South Brisbane, Australia (P.G.); Department of Radiation Oncology , Liverpool Hospital, Liverpool, Australia (E.-S.K.); University of New South Wales, Sydney, Australia (E.-S.K., E.H.); Department of Medical Oncology , Prince of Wales Hospital , Sydney, Australia (E.H.)
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Management of low-grade gliomas: a review of patient-perceived quality of life and neurocognitive outcome. World Neurosurg 2014; 82:e299-309. [PMID: 24560709 DOI: 10.1016/j.wneu.2014.02.033] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 11/08/2013] [Accepted: 02/18/2014] [Indexed: 01/23/2023]
Abstract
Low-grade glioma (LGG) comprises nearly 20% of all central nervous system glial tumors, with approximately 2000-3000 patients diagnosed annually in the United States. Because of their infiltrative ability and aggressive nature, the average 10-year survival is 30% when <90% of the tumor is resected. Since the 1970s, prognosis for LGGs has improved significantly. This improvement is primarily attributable to earlier diagnoses via magnetic resonance imaging scanning, increased awareness of the more favorable oligo component, technical advances in intraoperative neurosurgery, and stratification for young age. Using a number of prognostic factors, LGGs have been classified into low-risk and high-risk subgroups. Optimal therapy for patients with low-risk, supratentorial grade II glioma remains a highly controversial issue in the neuro-oncology community. The concerns regarding the toxicity of therapy often outweigh the benefits of delaying tumor progression. The recommendation for observation is made without full prospective understanding of the impact of radiologic tumor progression on the quality of life (QOL), neurocognitive function (NCF), seizure control, and functional status of these patients. We present a review of the current knowledge of the management of LGG with emphasis upon patient-reported outcomes of QOL, NCF, and seizure control. We also discuss current clinical trials with proposals to evaluate QOL, NCF, and seizure control in patients undergoing observation alone after newly diagnosed low-risk LGG or treatment options for those patients in the high-risk group.
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17
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Dirven L, Reijneveld JC, Aaronson NK, Bottomley A, Uitdehaag BMJ, Taphoorn MJB. Health-related Quality of Life in Patients with Brain Tumors: Limitations and Additional Outcome Measures. Curr Neurol Neurosci Rep 2013; 13:359. [DOI: 10.1007/s11910-013-0359-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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