Artikel
Preserving neurological function and quality of life – Assessment of predictors in a multicentric prospective trial in 175 patients with gliomas in an outpatient setting
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Autoren
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Mirjam Renovanz
- Klinik für Neurochirurgie, Universitätsmedizin Mainz, Mainz
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Marlene Hechtner
- Institut für medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin Mainz
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Jan Coburger
- Klinik für Neurochirurgie, Universität Ulm, Standort Günzburg, Günzburg
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Minou Nadji-Ohl
- Neurochirurgische Klinik, Klinikum Stuttgart, Stuttgart
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Alf Giese
- Klinik für Neurochirurgie, Universitätsmedizin Mainz, Mainz
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Christian Rainer Wirtz
- Klinik für Neurochirurgie, Universität Ulm, Standort Günzburg, Günzburg
| Veröffentlicht: | 2. Juni 2015 |
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Gliederung
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Objective: Even though, neurooncological treatment is multidisciplinary, neurosurgeons are in key positions for decision making in glioma patients. In this prospective study we aim to assess possible predictors for patients’ need for psychosocial support during the course of the disease.
Method: In 3 study centers glioma patients were prospectively included and interviewed using questionnaires to assess quality of life (EORTC QLQ-C30+BN20), psychooncological distress (Distress Thermometer) and supportive care needs (SCNS-SF34-G). Socio-demographic data, perioperative data (e.g. (eloquent) localization of the tumor), and clinical data (ECOG/KPS, adjuvant therapies) were assessed and influence on the above mentioned scores was analyzed by multivariate linear and logistic regression models.
Results: 175 patients were included with a m:f ratio 1.1:1.0, mean age was 50.9 years (SD=13.9, range 21-78). Distribution of WHO° was as follows: °I n=2 (1%), °II n=32 (18%), °III n=76 (43%), °IV n=66 (37%). 48 (27.3%) patients suffered from recurrent tumors, 54 (30.7%) of all tumors were located in eloquent brain, in 43 (24.4%) patients a subtotal resection(STR) was seen. With regard to the sociodemographic data, most of the patients lived in partnerships (77%), 60.3% had children. In regression analysis models study center, gender, profession, age, WHO°, and current chemotherapy were not associated with a requirement for psychosocial support according to DT>6. Whereas “KPS” was found to significantly influence patients’ wish and objective need for psychosocial support (p>0.0001, CI: 0.881-0.963). Linear regression for global health status (EORTC, C30) showed that cognitive functioning was influenced by localization of the tumor.
Conclusions: Our data show that preserving KPS is crucial for glioma patients’ quality of life and further need for psychological support. In the light of supramaximal resections demonstrating significant survival advantages for these patients equal attention must be paid to preservation of neurological and neurocognitive status.
