Quality of life in adults with brain tumors: Current knowledge and future directions

Abstract

Quality of life is an important area of clinical neurooncology that is increasingly relevant as survivorship increases and as patients experience potential morbidities associated with new therapies. This review of quality-of-life studies in the brain tumor population aims to summarize what is currently known about quality of life in patients with both low-grade and high-grade tumors and suggest how we may use this knowledge to direct future research. To date, reports on quality of life have been primarily qualitative and focused on specific symptoms such as fatigue, sleep disorders, and cognitive dysfunction, as well as some symptom clusters. However, the increasing interest in exploring quality of life as a primary end point for cancer therapy has established a need for prospective, controlled studies to assess baseline and serial quality-of-life parameters in brain tumor patients in order to plan and evaluate appropriate and timely interventions for their symptoms.

Illness intrusiveness and subjective well-being in patients with glioblastoma

“…This disease is associated with neurological sequelae that affect physical and cognitive functioning [2]. Despite advances in treatment [3] prognosis remains poor, with survival ranging from 7.5 to 36 months (median 14.6 months) for patients who receive surgery and radiation with concurrent and adjuvant temozolomide chemotherapy [3].…”

Diagnosis, treatment, and prognosis of glioma

“…There is a lot of caregiver and patient anxiety about how brain tumor patients die and we desperately need more knowledge about this phase of the end of life. An Italian study of 169 brain tumor (primary and malignant) patients who died at home 12 and a study from the Netherlands involving 55 HGG patients 13 found very similar results regarding the incidence of key symptoms in the last weeks of life. Seizures occurred in nearly half of the patients, especially in the last week of life.…”

“…Cause of death was presumed brain herniation 73% of the time, the remainder due to pulmonary embolism, infection, bowel perforation from steroid use, and following seizures. In the Netherlands study, 13 66% died at home, 17% died in the hospital, and 8.5% each for hospice and nursing home. There is a pressing need for better designed, prospective QOL studies of brain tumor patients and their caregivers; currently our European colleagues appear to be leading the way.…”

A Survey of MRI Segmentation Techniques for Brain Tumor Studies

“…People suffering from brain tumors exhibit certain symptoms as the disease progresses some of which include headache, vomiting, seizures, fatigue, vision related problems, difficulty in speaking, impediment of sensation and walking and feeling unconscious [3]. The diagnosis of these tumors is usually by medical examination of symptoms along with the use of medical imaging techniques such as Computed Tomography (CT) or Magnetic Resonance imaging for the analysis of the tumor affected brain images.…”