Quality of life in patients with stable disease after surgery, radiotherapy, and chemotherapy for malignant brain tumour

A R Giovagnoli, A R Giovagnoli

Abstract

Objectives: to evaluate quality of life in patients with malignant brain tumour with stable disease after combined treatments in comparison to patients with other chronic neurological conditions, and to explore the relation of quality of life to clinical, pathological, affective and cognitive factors.

Methods: fifty seven patients who were stable after surgery, radiotherapy and chemotherapy and 24 controls with spastic paraparesis, peripheral neuropathies, myasthenia, ataxia, Parkinson's disease, or multiple sclerosis, were studied. Patients were evaluated by functional living index-cancer, Karnofsky performance status, activity of daily living, self-rating depression scale, state-trait anxiety inventory, and tests for cognitive abilities.

Results: separate Mann-Whitney test comparisons did not show any difference in measures of health related quality of life (functional living index-cancer), autonomy in daily life (activity of daily living), or mood between tumour and control patients, although the first had slower mental speed and worse attention. Seventy three per cent of patients with brain tumour and 58% of the control patients continued or resumed previous work activity. Quality of life was significantly associated with depression, state anxiety, and performance status in the patients with brain tumour, whereas in control patients, state anxiety was the only factor related to quality of life.

Conclusions: after intensive multimodality treatments, selected patients with brain tumour with stable disease may have satisfactory quality of life that may be not worse than in patients with other chronic neurological illnesses. During the period of stable disease, depressed mood, possibly a reaction to impaired physical and cognitive performance, seems to play a major role in determining quality of life.

References

    1. Ital J Neurol Sci. 1994 Dec;15(9):481-8
    1. Arch Gen Psychiatry. 1965 Jan;12:63-70
    1. Gerontologist. 1970 Spring;10(1):20-30
    1. J Neurosurg. 1978 Sep;49(3):333-43
    1. Neurology. 1980 Feb;30(2):172-7
    1. Cancer. 1980 Apr 15;45(8):2220-4
    1. Cancer. 1981 Feb 15;47(4):649-52
    1. J Clin Oncol. 1984 May;2(5):472-83
    1. Am J Clin Oncol. 1987 Apr;10(2):156-62
    1. Neurosurgery. 1987 Aug;21(2):201-6
    1. Funct Neurol. 1987 Apr-Jun;2(2):189-94
    1. Cancer. 1988 Feb 15;61(4):849-56
    1. Ann Neurol. 1990 Dec;28(6):818-22
    1. Cancer. 1991 Jun 15;67(12):3131-5
    1. J Neurol Neurosurg Psychiatry. 1992 May;55(5):372-6
    1. J Neurooncol. 1992 Nov;14(3):243-53
    1. Int J Radiat Oncol Biol Phys. 1993 Apr 30;26(1):129-33
    1. Cancer Nurs. 1994 Apr;17(2):137-40
    1. Cancer. 1995 Mar 1;75(5):1151-61
    1. Qual Life Res. 1996 Feb;5(1):139-50
    1. BMJ. 1996 Dec 14;313(7071):1512-6
    1. Int J Radiat Oncol Biol Phys. 1996 Dec 1;36(5):1163-7
    1. Int J Radiat Oncol Biol Phys. 1998 Jan 15;40(2):287-95
    1. Int J Radiat Oncol Biol Phys. 1998 Feb 1;40(3):653-9
    1. J Neurooncol. 1996 Oct;30(1):71-80

Source: PubMed

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