Health-related quality of life and clinical outcome after radiotherapy of patients with intracranial meningioma

Abstract

This retrospective, single-institutional study investigated long-term outcome, toxicity and health-related quality of life (HRQoL) in meningioma patients after radiotherapy. We analyzed the data of 119 patients who received radiotherapy at our department from 1997 to 2014 for intracranial WHO grade I-III meningioma. Fractionated stereotactic radiotherapy (FSRT), intensity modulated radiotherapy (IMRT) or radiosurgery radiation was applied. The EORTC QLQ-C30 and QLQ-BN20 questionnaires were completed for assessment of HRQoL. Overall survival (OS) for the entire study group was 89.6% at 5 years and 75.9% at 10 years. Local control (LC) at 5 and 10 years was 82.4% and 73.4%, respectively. Local recurrence was observed in 22 patients (18.5%). Higher grade acute and chronic toxicities were observed in seven patients (5.9%) and five patients (4.2%), respectively. Global health status was rated with a mean of 59.9 points (SD 22.3) on QLQ-C30. In conclusion, radiotherapy resulted in very good long-term survival and tumor control rates with low rates of severe toxicities but with a deterioration of long-term HRQoL.

Figure 1

(a) Comparison of QLQ-C30 functional scales with previously published data. Higher scores in functional domains suggest higher level of functioning and better quality of life. QL2 = Global health status (revised); PF2 = Physical functioning (revised); RF2 = Role functioning (revised); EF = Emotional functioning; CF = Cognitive functioning; SF = Social functioning. (b) Comparison of QLQ-C30 symptom scales with previously published data. Higher scores in symptomatic domains suggest lower level of functioning and worse quality of life. Abbreviations: FA = Fatigue; NV = Nausea and vomiting; PA = Pain; DY = Dyspnea; SL = Insomnia; AP = Appetite loss; CO = Constipation; DI = Diarrhea; FI = Financial difficulties. *Data not published.

Figure 2

Local control shown by Kaplan–Meier analysis for all patients (a) and stratified by the WHO grading (b). WHO grading was suggestive for influencing local control (p = 0.05). Overall survival shown by Kaplan–Meier analysis for all patients (c) and stratified by the WHO grading (d). WHO grading was highly significant for overall survival (p = 0.002).