HRQoL stable in glioblastoma patients after escalation 5-fraction stereotactic radiosurgery
Health-related quality of life (HRQoL) remains constant in glioblastoma patients who underwent the prospective dose escalation trial of 5-fraction stereotactic radiosurgery with concurrent and adjuvant temozolomide, a new study shows.
The HRQoL of 30 trial participants (median age 66 years; 50 percent male) was assessed using the QoL questionnaire core-30 (QLQ-C30) and QoL questionnaire-brain cancer specific (QLQ-BN20) modules of the European Organization for Research and Treatment of Cancer, and the M.D. Anderson Symptom Inventory-Brain Tumour (MDAST-BT) questionnaire.
The investigators found a significant reduction of 1.72 points per month from baseline in the communication deficit scale (p=0.008). The false discovery rate was calculated to be 7 percent which indicates that the result was true discovery.
Over a median follow-up of 13.5 months, 26 participants experienced disease progression yielding a 12-month cumulative incidence of 64 percent. Disease progression was significantly associated with communication deficit (p=0.01).
In contrast, there were no significant changes from baseline in terms of global QoL, physical, social and emotional functioning, motor dysfunction, future uncertainty, insomnia and fatigue.
The 12-month cumulative incidence of adverse radiation effects (AREs) was 28 percent (n=8), of which 75 percent (n=6) were symptomatic. AREs were not significantly associated with any of the measures of HRQoL.
Aside from communication deficits, HRQoL was stable in five long-term survivors with a median follow-up of 34.7 months.
All study participants had supratentorial glioblastoma and were treated with increasing doses of hypofractionated stereotactic radiosurgery. Four radiation doses were used: 25, 30, 35 and 40 Gy.