Quality of life following concurrent temozolomide-based chemoradiation therapy or observation in low-grade glioma

Deborah Y Park¹, Martin C Tom², Wei Wei³, Surabhi Tewari¹, Manmeet S Ahluwalia², Jennifer S Yu^{1

4}, Samuel T Chao^{1

4

5}, John H Suh^{1

4

5}, David Peereboom^{1

5}, Glen H J Stevens^{1

5}, Gene H Barnett^{1

5

6}, Lilyana Angelov^{1

5

6}, Alireza M Mohammadi^{1

5

6}, Thomas Hogan⁷, Courtney Kissel⁷, Brittany Lapin³, Isabel Schuermeyer⁸, Michael W Parsons⁹, Richard Naugle^{1

7}, Erin S Murphy^{10

11

12}

Affiliations

¹ Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, OH, USA.
² Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA.
³ Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue / CA-60, Cleveland, OH, 44195, USA.
⁴ Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, 9500 Euclid Avenue / CA-50, Cleveland, OH, 44195, USA.
⁵ Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center and Neurological institute, Cleveland Clinic, Cleveland, OH, USA.
⁶ Department of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA.
⁷ Department of Neuropsychology, Cleveland Clinic, Cleveland, OH, USA.
⁸ Department of Psychiatry, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
⁹ Neuro-Oncology Center and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
¹⁰ Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, OH, USA. murphye3@ccf.org.
¹¹ Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, 9500 Euclid Avenue / CA-50, Cleveland, OH, 44195, USA. murphye3@ccf.org.
¹² Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center and Neurological institute, Cleveland Clinic, Cleveland, OH, USA. murphye3@ccf.org.

PMID: 35064450
DOI: 10.1007/s11060-021-03920-6

Quality of life following concurrent temozolomide-based chemoradiation therapy or observation in low-grade glioma

Deborah Y Park et al. J Neurooncol. 2022 Feb.

. 2022 Feb;156(3):499-507.

doi: 10.1007/s11060-021-03920-6. Epub 2022 Jan 22.

Authors

Affiliations

¹ Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, OH, USA.
² Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA.
³ Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue / CA-60, Cleveland, OH, 44195, USA.
⁴ Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, 9500 Euclid Avenue / CA-50, Cleveland, OH, 44195, USA.
⁵ Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center and Neurological institute, Cleveland Clinic, Cleveland, OH, USA.
⁶ Department of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA.
⁷ Department of Neuropsychology, Cleveland Clinic, Cleveland, OH, USA.
⁸ Department of Psychiatry, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
⁹ Neuro-Oncology Center and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
¹⁰ Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, OH, USA. murphye3@ccf.org.
¹¹ Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, 9500 Euclid Avenue / CA-50, Cleveland, OH, 44195, USA. murphye3@ccf.org.
¹² Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center and Neurological institute, Cleveland Clinic, Cleveland, OH, USA. murphye3@ccf.org.

PMID: 35064450
DOI: 10.1007/s11060-021-03920-6

Abstract

Purpose: Low-grade glioma (LGG) exhibits longer median survival than high-grade brain tumors, and thus impact of our therapies on patient quality of life remains a crucial consideration. This study evaluated the effects of concurrent temozolomide-based chemoradiation (RT + TMZ) or observation on quality of life (QOL) in patients with low-grade glioma.

Methods: We completed a retrospective cross-sectional study of adults with LGG who underwent surgery with known molecular classification from 1980 to 2018. Postoperatively, patients were either observed or received adjuvant concurrent temozolomide-based chemoradiation. EQ-5D and PHQ-9 depression screen were completed before outpatient visits every 2-3 months. Baseline score was defined as ± 30 days within initial operation.

Results: Of the 63 patients (mean age 44 ± 17 years, 51% female) with baseline EQ-5D or PHQ-9 depression screen data and at least one follow-up measure, 30 (48%) were observed and 33 (52%) received RT + TMZ. No significant decline was seen in EQ-5D or PHQ-9 scores at 3, 6, 9, 12, and 24 months compared to baseline scores for all patients. At each time point, there was no significant difference between those who were observed or received adjuvant therapy. The linear mixed model estimating PHQ-9 value or EQ-5D index demonstrated that there was no significant difference in PHQ-9 or EQ-5D index between treatment groups (p = 0.42 and p = 0.54, respectively) or time points (p = 0.24 and p = 0.99, respectively).

Conclusion: Our study found no significant decline in patient QOL or depression scores as assessed by patient- reported outcome measures for patients with low-grade glioma up to 2 years following surgery. We found no difference between RT + TMZ compared to observation during this time frame. Additional follow-up can help identify the longer-term impact of treatment strategy on patient experience.

Keywords: Chemoradiation; EQ-5D; Low grade glioma; PHQ-9; Quality of life; Temozolomide.

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References

1. Claus E, Black P (2006) Survival rates and patterns of care for patients diagnosed with supratentorial low-grade gliomas: data from the SEER program, 1973–2001. Cancer 106:1358–1363. https://doi.org/10.1002/cncr.21733 - DOI - PubMed
1. Murphy ES, Leyrer CM, Parsons M et al (2018) Risk factors for malignant transformation of low-grade glioma. Int J Radiat Oncol Biol Phys 100:965–971. https://doi.org/10.1016/j.ijrobp.2017.12.258 - DOI - PubMed
1. Tom MC, Park DY, Yang K et al (2019) Malignant transformation of molecularly classified adult low-grade glioma. Int J Radiat Oncol Biol Phys 105:1106–1112 - DOI
1. van den Bent MJ, Afra D, de Witte O et al (2005) Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet Lond Engl 366:985–990. https://doi.org/10.1016/S0140-6736(05)67070-5 - DOI
1. Pignatti F, van den Bent M, Curran D et al (2002) Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol 20:2076–2084. https://doi.org/10.1200/JCO.2002.08.121 - DOI - PubMed

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Quality of life following concurrent temozolomide-based chemoradiation therapy or observation in low-grade glioma

Affiliations

Quality of life following concurrent temozolomide-based chemoradiation therapy or observation in low-grade glioma

Authors

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Abstract

References

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Medical