Long-Term QOL Decline Seen in Some Low-Grade Glioma Survivors

Oligodendroglioma: MRI T1 with gadolinium contrast, coronal section; source: RadsWiki, Wikimedia Commons

Patients who were stable, long-term survivors of low-grade glioma were able to maintain a high level of health-related quality of life, according to a recent study; however, some survivors did experience detectable declines in certain areas, such as physical functioning.

According to study researcher Florien W. Boele, MSc, of VU University Medical Center in Amsterdam, and colleagues, very little data are available looking at health-related quality of life in patients with low-grade glioma and stable disease extending beyond 6 years from initial diagnosis. Therefore, in this analysis, they looked at general and disease-specific health-related quality of life in a group of low-grade glioma survivors at 6 years (n = 195) and 12 years (n = 67) post-diagnosis and compared them with healthy controls.

“We found mild compromise in health-related quality of life, with patients with low-grade glioma scoring significantly lower on the subscales of physical role functioning and general health perceptions compared with controls from the general population at long-term follow-up,” the researchers wrote in the Journal of Clinical Oncology.

No significant differences of self-report measures of generic health-related quality of life (Short Form-36) and disease-specific health-related quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–Brain Cancer Module) between the two groups were observed at the mid-term follow-up.

However, by the 12-year follow-up, patients with low-grade glioma and stable disease reported significantly worse physical functioning (mean 57.7 vs mean 78.8; P = .004) and general health perceptions (mean 63.8 vs mean 74.5; P = .004) compared with controls. Data showed that physical health and physical functioning in patients with glioma were significantly worse at 12 years than at 6 years (P < .001 for both).

Forty-eight percent of low-grade glioma survivors either improved or remained stable on all of the health-related quality of life scales examined in the study.

“In general, our analysis of detectable change revealed that the majority of patients maintain a stable level of health-related quality of life, indicating that in our cohort of patients with stable low-grade glioma, health-related quality of life is not severely compromised,” the researchers wrote. “This is potentially reassuring news for patients with low-grade glioma, their families, and their clinicians.”

However, 52% of patients with low-grade glioma in the study had decline on one or more of the scales, including 38.5% who had a detectable decline and 13.8% who experienced both detectable decline and improvement on one or more of the scales.

“Future studies into meaningful change, as well as the associations of patient-, disease-, or treatment-related variables with (decline in) health-related quality of life, are recommended to better aid patients with low-grade glioma in dealing with the possible mental and physical consequences of low-grade glioma,” the researchers wrote.