QL-20 PROGNOSTIC IMPORTANCE OF HEALTH-RELATED QUALITY OF LIFE AND FATIGUE IN NEWLY DIAGNOSED GLIOBLASTOMA

• Published in: Neuro-oncology (Charlottesville, Va.) Vol. 16; no. suppl 5; p. v182
• Main Authors: Peters, K., Randazzo, D., Affronti, M., Lipp, E., McSherry, F., Herndon, J., Flahiff, C., Miller, E., Woodring, S., Freeman, M., Healy, P., Minchew, J., Boulton, S., Desjardins, A., Ranjan, T., Vlahovic, G., Jones, L., Friedman, H.
• Format: Journal Article
• Language: English
• Published: 01-11-2014
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/nou269.19

After diagnosis, glioblastoma (GBM) patients quickly experience the neurological, physical, and emotional impact of their disease. Even before chemoradiation treatment, health-related quality of life (HRQoL) can be impaired and fatigue can be present due to neurological dysfunction, co-morbidities (e.g. seizures, depression), and medications (e.g. corticosteroids, anti-epileptics). We evaluated the impact of HRQoL and fatigue on survival in newly diagnosed GBM. Data collected within the Preston Robert Tisch Brain Tumor Center at Duke as part of the PRoGREss registry between 11/21/2011 and 10/10/2013 were queried retrospectively. In addition to demographic and clinical information, data were obtained from patient-reported outcome questionnaires including Functional Assessment of Cancer Therapy-Brain Cancer (FACT-Br) and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). Cox proportional hazard models were utilized to evaluate the effect of HRQoL and fatigue on overall survival. For this study, 322 subjects were identified. Mean age was 59 (SD = 13) years. KPS ranged from 40-100 with KPS greater than or equal to 90 for 36.7%, KPS = 80 for 34.5%, KPS less than or equal to 70 for 21.4% and unknown for 7.5%. In univariate Cox analyses, the FACT-Br Total (HR = 0.986 (CI 95%: 0.98, 0.992) and FACIT-F (HR = 0.969 (CI 95%: 0.955, 0.982)) were both significant predictors of overall survival. Both the FACT-Br Total and FACIT-F added prognostic information beyond that provided by KPS alone (Likelihood ratio (LR) p = 0.003 and p = 0.004, respectively), but did not provide additional prognostic information when KPS, age, gender, and extent of resection were added to the multivariate model (LR p = 0.17 and p = 0.19, respectively). In fact, the strongest predictor of overall survival in this population was extent of resection (gross total resection vs biopsy, (HR = 3.11 (CI 95%: 2.12, 4.57))). Based on these findings, HRQoL and fatigue in newly diagnosed GBM are independent predictors of survival that provide incremental prognostic value to KPS but not to other prognostic factors such as extent of resection.