Health-related quality of life of glioblastoma patients receiving post-operative concomitant chemoradiotherapy plus adjuvant chemotherapy: A longitudinal study

Abstract

Background: Glioblastoma (GBM) is an aggressive primary malignant brain tumour with a dismal prognosis, despite the improvement from the new establishment of post-operative treatment protocol of concomitant chemoradiotherapy (CCRT) plus adjuvant chemotherapy. This study aimed to evaluate the health-related quality of life (HRQoL) in post-operative GBM patients treated with CCRT plus adjuvant chemotherapy with subjective standardised questionnaires at various time points. Methods: Patients with newly diagnosed GBM who were treated at our centre with post-operative CCRT plus adjuvant chemotherapy were included. Their HRQoL scales were measured with the European Organisation for Research and Treatment of Cancer (EORTC) CLC30 and BN20 questionnaires. Assessments were made before the beginning of post-operative CCRT, and at 0 (within 2 weeks), 3 and 6 months after the end of CCRT. A mixed-level linear model was used to analyse the change in each HRQoL scale over time. Results: 21 patients were recruited with a median overall survival of 27 months (range:4–55 months). There was no significant change in the global health status over time. An improvement in insomnia and an aggravation in communication deficit were found with statistical significance and clinical meaningfulness. Greater improvement in insomnia was associated with methylated MGMT gene promoter in the tumour while worse aggravation in communication deficit was associated with older age (≥65). Conclusions: The global health status did not worsen during post-operative CCRT plus adjuvant chemotherapy, while the severity of insomnia lessened and communication deficit worsened. This may provide insight for clinicians to formulate treatment plan for patients with GBM.