gms | German Medical Science

Objective: Recent literature clearly demonstrates that early diagnosis and treatment of increased psycho-oncological distress facilitates an optimized medical treatment for malignant glioma patients. But until now there is no standardized assessment that enquires the need for psycho-oncological treatment. Likewise, less is known about the longitudinal development as well as the optimal screening and therapy time point of increased distress.

Methods: Patients with malignant brain tumors were screened for their psycho-oncological treatment demand perioperatively as well as 3-monthly in the course of disease. Three different self-assessment instruments were used (Hospital Anxiety and Depression Scale, Distress Thermometer) as well as one external assessment questionnaire (Psycho-oncological base documentation). HRQOL was assessed by the EORTC-C30-BN20.

Results: Since April 2012, 512 patients (median age 56 years, 291 men, 221 women) were screened for their psychooncological distress at our neurosurgical department (median observation time 27 months). Overall 139 patients (27%) asked for psychooncological support during the course of therapy. Perioperatively we observed an increased distress (median 53,2%) independent from resection time point (first resection: 53,2%, first re-resection 50,6%, second re-resection 53,8%). According to the follow up screenings the psychooncological distress is constantly high (median 44,4%). The Mc Nemar test shows a significant difference between the perioperatively distress at the initial diagnosis and the first follow-up screening after three month (p = 0,12, n=69). Concerning the HRQOL assessment perioperatively we observed a decreased life-quality (median 81,6%) and increased future uncertainty (median 36,1%).

Conclusion: Our preliminary results demonstrate a high incidence of increased distress especially perioperatively and underline the impact of distress screening and psycho-oncological support for patients with malignant brain tumors. Ongoing evaluation of our data will analyze the longitudinal development during the course of illness and try to identify important predictive factors for increased distress.