Prognostic value of health‐related quality of life for death risk stratification in patients with unresectable glioblastoma

Abstract

Glioblastoma is the most common malignant brain tumor in adults. Baseline health‐related quality of life (HRQoL) is a major subject of concern for these patients. We aimed to assess the independent prognostic value of HRQoL in unresectable glioblastoma (UGB) patients for death risk stratification. One hundred and thirty‐four patients with UGB were enrolled from the TEMAVIR trial. HRQoL was evaluated at baseline using the EORTC QLQ‐C30 and BN20 brain cancer module. Clinical and HRQoL parameters were evaluated in univariable and multivariable Cox analysis as prognostic factors for overall survival (OS). Performance assessment and internal validation of the final model were evaluated with Harrel's C‐index, calibration plot, and bootstrap sample procedure. Two OS independent predictors were identified: future uncertainty and sensitivity deficit. The final model exhibited good calibration and acceptable discrimination (C statistic = 0.63). The internal validity of the model was verified with robust uncertainties around the hazard ratio. The prognostic score identified three groups of patients with distinctly different risk profiles with median OS estimated at 16.2, 9.2, and 4.5 months. We demonstrated the additional prognostic value of HRQoL in UGB for death risk stratification and provided a score that may help to guide clinical management and stratification in future clinical trials.

Returning to work after multimodal treatment in glioblastoma patients

“…There is no doubt that the increased incidence of GBM and the improvement in the treatment outcome will result in a higher prevalence of survivors, 12 but the HRQOL and functional outcome of these patients has so far been the subject of only a few studies. 4,5,7,13,15,16,19,20 Paquette et al 19 identified future uncertainty in unresectable GBMs as an independent predictor factor for OS, which was in line with financial worries. The ability to provide for one's economic self-sustenance not only impacts a person's socioeconomic quality of life but also affects the sense of future certainty and influences his or her self-worth and can be considered as a parameter of social reintegration.…”

“…to the working capacity and not only allows individuals to maintain their social status but also affects the sense of future certainty, 19 which has been shown to represent an additional prognostic value for death risk stratification in unresectable GBM. 19 Numerous factors come into play in the socio-economic analysis of GBM patients, and the parameters to consider are multifactorial.…”

“…to the working capacity and not only allows individuals to maintain their social status but also affects the sense of future certainty, 19 which has been shown to represent an additional prognostic value for death risk stratification in unresectable GBM. 19 Numerous factors come into play in the socio-economic analysis of GBM patients, and the parameters to consider are multifactorial. Cognitive and functional deficits and the direct effects of chemoradiotherapy could impact differently the ability to return to work, depending on the socio-professional category of the patient, as well as the socio-cultural context and specific health care system of each country.…”

Development of screening questions for doctor–patient consultation assessing the quality of life and psychosocial burden of glioma patients: an explorative study

“…In self-assessments, however, a high nonresponse rate could be specific for glioma [ 14 ] since various physical and neuropsychological symptoms can complicate the use of screening instruments [ 15 ]. It is possible that the true rates of distress, mental and cognitive problems are higher than reported [ 16 ].…”

Technobiology Paradigm in Nanomedicine: Treating Cancer with MagnetoElectric Nanoparticles

“…Despite multidisciplinary treatment approaches, including surgical resection and radiotherapy, GBM has a low prognosis with an average survival period of 15 -18 months (124)(125)(126). A major challenge in the treatment of GBM is delivering the therapeutic drug across the blood-brain barrier (BBB), a network of specialized brain endothelial cells with intercapillary distances of ~40µm that tightly regulate ionic composition, prevent macromolecules and unwanted cells from entering the brain to protect the central nervous system (CNS) from neurotoxins (127)(128)(129)(130)(131).…”