Artikel
Health related quality of life and distress in elderly patients(≥65y) with high-grade glioma – post-hoc analysis of the ERASMUS study
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Autoren
-
Mirjam Renovanz
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Anne-Katrin Hickmann
- Klinikum Stuttgart, Neurochirurgische Klinik, Stuttgart, Deutschland; Schulthess Klinik, Zürich, Deutschland
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Naureen Keric
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Minou Nadji-Ohl
- Klinikum Stuttgart, Neurochirurgische Klinik, Stuttgart, Deutschland
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Florian Ringel
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Jan Coburger
- Universitätsklinikum Ulm/Günzburg, Neurochirurgische Klinik, Ulm/Günzburg, Deutschland
| Veröffentlicht: | 18. Juni 2018 |
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Gliederung
Text
Objective: Half of all newly diagnosed patients with glioblastoma are >65 years and this number is expected to increase due to the ageing population in the western world. With a median survival of less than 6 months the prognosis in the elderly remains poor. Preserving quality of life is of high importance. However patient reported outcome (PRO) data in this patient group rare. The aim was to
- 1.
- analyze PROs of the elderly cohort of high-grade glioma patients (HGG) in the outpatient clinical setting and
- 2.
- to compare the data with the younger subpopulation.
Methods: PRO assessment results were obtained during ERASMUS study using the Distress Thermometer (DT), European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) plus brain module (BN20). They were screened for data of a subpopulation of patients ≥65y with high-grade glioma (GBM/AA°III). Scores of DT and subscales of EORTC instruments in patients ≥65y were exploratively compared to those of patients younger than 65y (clinically meaningful in subscales is a difference of 5-14; t-test, Mann-Whitney-test).
Results: N=84 (39%) out of n=216 patients were ≥65y (mean=71y, range=65-86y). The majority harbored a GBM (n=68, 81%), n=42 (50%) were male, n=59 (70%) had primary diagnosis and n=44 (52%) were under chemotherapy, median KPS was 80 (range 40-100). The mean DT score was similar between males and females (4.7 vs. 4.9) as well as elderly and younger patients (4.8 vs. 4.6, p=0.79). With regard to EORTC-QLQ-C30+BN20 assessments we found in univariate analyses significantly lower Global Health Status scores in elderly HGG patients compared to younger ones (median elderly vs. younger 58.3 vs. 66.7, p=0.008), lower physical (PF) and emotional functioning (EF) (median elderly vs. younger: PF 60 vs. 86.7, p=0.001; EF: 66.7 vs. 58.3, p=0.04) and higher motor dysfunction (median elderly vs. younger: 22 vs. 11, p=0.007). No differences were found in the subscales "social functioning", "fatigue" and "future uncertainty". All reported differences between groups are clinically meaningful.
Conclusion: Despite the relatively high KPS (which is physician-estimated) elderly HGG patients seem to be more affected by the disease than younger ones with regard to physical impairment highlighting the frailty of many elderly patients. This should be taken into account when planning therapies in HGG in clinical routine.
