gms | German Medical Science

67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Does type of recurrence therapy have an impact on quality of life? A prospective multicenter analysis of 110 high-grade glioma patients in outpatient setting

Meeting Abstract

  • Linda Stöckelmaier - Klinik für Neurochirurgie, Universität Ulm, Standort Günzburg, Günzburg, Germany
  • Mirjam Renovanz - Klinik für Neurochirurgie, Universitätsmedizin Mainz, Mainz, Germany
  • Anne Hickmann - Zentrum für Minimalinvasive und Endoskopische Neurochirurgie, Klinik Hierslanden, Zürich, Switzerland
  • Alf Giese - Klinik für Neurochirurgie, Universitätsmedizin Mainz, Mainz, Germany
  • Christian Rainer Wirtz - Klinik für Neurochirurgie, Universität Ulm, Standort Günzburg, Günzburg, Germany
  • Jan Coburger - Klinik für Neurochirurgie, Universität Ulm, Standort Günzburg, Günzburg, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMO.03.02

doi: 10.3205/16dgnc009, urn:nbn:de:0183-16dgnc0094

Veröffentlicht: 8. Juni 2016

© 2016 Stöckelmaier et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: In this prospective study we aim to assess quality of life (QoL) in high-grade glioma(HGG) patients in case of recurrence depending on 2nd line treatment regime. As the case of recurrence represents a palliative situation it is especially essential to consider QoL concerning different therapy options.

Method: As part of a prospective multicenter study we assessed QoL in 265 glioma patients from 2013 to 2015 using EORTC QLQ-C30+BN20 questionnaire. We analyzed the influence on quality of life depending on different relapse treatments like surgery, 2nd and 3rd line chemotherapies and secondary radiation. Distribution, mean value of single items and subscores were calculated by explorative data analysis while the significance was estimated by t-test or ANOVA.

Results: 91 patients were included in total. F:m ratio was 1.1:1.0 and the mean age was 56 years. The relationship between WHO° IV and III was 3.38:1.0. The majority of lesions were found frontally (39%), temporally (30%), or parietally (26%) located. By comparing patients’ performance in 2nd-line chemotherapies (such as Temozolomide (TMZ) 7/7, TMZ 5/28 and Bevacizumab) to patients in 3rd-line chemotherapy (e.g. Lomustin, Cabazitaxel, BSC and others) there is no significant difference in QoL. Pointing out the treatment after second surgery it was shown that drowsiness and dyspnea were more severe in ongoing chemotherapy in comparison to radiation. No significant difference in QoL was found until the 2nd recurrent surgery. After 4th surgery QoL dropped and patients showed a significant higher fatigue than after previous surgeries (p<0.022). With regard to seizures it was shown that patients with repetitive recurrent surgeries had a better seizure control compared to those with fewer or even none. A repeated combined radiochemotherapy after recurrent surgery showed a significant impact on several symptoms affecting QoL of patient. Following items were affected: fatigue, dyspnea, appetite loss, financial difficulties, drowsiness and itchy skin.

Conclusions: It was shown that repeated recurrent surgeries do not have a negative impact on QoL while seizure control was improved. Selection bias should be taken into account, as patients undergoing several re-surgery in glioma disease are a rare. 3rd-line chemotherapies do not negatively influence compared to 2nd-line chemotherapy. A combined radiochemotherapy after recurrent surgery impairs patients QoL considerably.