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Quality of Life Perception, Cognitive Function, and Psychological Status in a Real-world Population of Glioblastoma Patients Treated With Radiotherapy and Temozolomide

A Single-center Prospective Study

Lombardi, Giuseppe, MD, PhD*; Bergo, Eleonora, BSc*; Del Bianco, Paola, BSc; Bellu, Luisa, MD; Pambuku, Ardi, MD*; Caccese, Mario, MD*; Trentin, Leonardo, MD§; Zagonel, Vittorina, MD*

American Journal of Clinical Oncology: December 2018 - Volume 41 - Issue 12 - p 1263–1271
doi: 10.1097/COC.0000000000000459
Original Articles: Central Nervous System

Background: Health-related quality of life (HRQoL), cognitive function, and psychological status represent an important focus during the treatment of glioblastoma patients. Nevertheless, few randomized, prospective clinical trials have analyzed these factors, and very little is known in the real-clinical world. We evaluated these characteristics in glioblastoma patients treated with standard first-line therapy outside clinical trials.

Patients and Methods: In total, 111 newly, histologically diagnosed glioblastoma patients treated at our oncology center with radiotherapy and temozolomide were prospectively enrolled. No patient was enrolled in an experimental clinical trial. We assessed HRQoL, cognitive function, and psychological status before starting treatment, at the end of radiotherapy, and every 3 months until 9 months after the end of radiotherapy using EORTC QLQ-C30, BN20, MMSE, and HADS questionnaires.

Results: Global health status, physical, cognitive, and social functioning remained unchanged throughout the study period. A statistically significant change was found in emotional functioning as well as a clinically meaningful amelioration in role functioning between the baseline assessment and 9 months after radiotherapy. Patients older than 65 years reported greater impairment on the bladder control scale than younger patients. When considering tumor location, global health status, communication deficit, and drowsiness, scores were significantly different between the right and left hemispheres. Female patients had a clinically relevant lower score for physical functioning at baseline and 3 months after radiation therapy. Female patients also had a clinically relevant lower depression score at 9 months after radiation therapy.

Conclusions: In routine neurooncology practice, HRQoL, cognitive function, and psychological status did not worsen during first-line treatment in glioblastoma patients receiving standard radiotherapy and temozolomide treatment. However, some patient subgroups, such as elderly and female patients, may have different experiences with treatment, and further investigation is required.

*Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit

Clinical Trials and Biostatistics Unit

Radiation Therapy Unit

§Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy

The authors declare no conflicts of interest.

Reprints: Giuseppe Lombardi, MD, PhD, Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit, Veneto Institute of Oncology, IOV-IRCCS, via Gattamelata, 64, Padua 35128, Italy. E-mail: giuseppe.lombardi@iov.veneto.it.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.