Symptom Burden in Glioblastoma: A Prospective Pilot Study from Diagnosis to First Progression

Abstract

Introduction: The evaluation of symptom burden, performance status and neurological function is still challenging in glioblastoma (GBM) patients. Patients may suffer from a wide spectrum of neurological symptoms like cognitive deficits, aphasia or hemiparesis, which interfere to report to comprehensive questionnaires. However, an integrated and reliable neuro-oncological assessment is key in the clinical management and in the evaluation of treatment benefits for GBM patients. Methods: We implemented an easy-to-use clinical toolkit for the prospective assessment and follow-up evaluation of GBM patients using the Karnofsky performance status (KPS), the National Institute of Health Stroke Scale (NIH-SS) and simple scores for the evaluation of key symptoms like fatigue, depression and headache. Results: We prospectively followed 50 patients. The composite score (headache, depression and fatigue), fatigue alone, the NIHSS and the KPS were suitable biomarkers to evaluate symptom burden in GBM patients and indicate clinical disease progression. Discussion/Conclusion: The proposed clinical toolkit seems feasible in routine clinical practice and reflects changes in symptom burden in different stages of the post-surgical course of GBM patients in this monocentric clinical pilot trial.

The Current Status, Challenges, and Future Potential of Therapeutic Vaccination in Glioblastoma

“…Glioblastoma (GBM) is the most common malignant primary brain tumor in adults, representing 14.2% of all central nervous system (CNS) tumors and 50.1% of all malignant tumors [1]. GBM is associated with a high symptom burden and a wide range of neurological symptoms, including cognitive deficits, focal weakness, headaches, and seizures, depending on the tumor's location [2]. The median overall survival (mOS) is poor at 15 months, despite maximal standard of care therapies [3][4][5].…”