Marijke Coomans1, Linda Dirven2, Neil K Aaronson3, Brigitta G Baumert4, Martin van den Bent5, Andrew Bottomley6, Alba A Brandes7, Olivier Chinot8, Corneel Coens6, Thierry Gorlia9, Ulrich Herrlinger10, Florence Keime-Guibert11, Annika Malmström12, Francesca Martinelli6, Roger Stupp13, Andrea Talacchi14, Michael Weller15, Wolfgang Wick16, Jaap C Reijneveld17, Martin J B Taphoorn2. 1. Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: m.b.coomans@lumc.nl. 2. Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Department of Neurology, Haaglanden Medical Center, Den Haag, the Netherlands. 3. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands. 4. Department of Radiation-oncology, University Hospital Bonn, Germany; Department of Radiation Oncology (MAASTRO Clinic), and GROW (School for Oncology and Developmental Biology), Maastricht University Medical Center, Maastricht, the Netherlands. 5. The Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, the Netherlands. 6. Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium. 7. Department of Medical Oncology, Azienda USL-IRCCS Institute of Neurological Sciences, Bologna, Italy. 8. Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service de Neuro-Oncologie, Marseille, France. 9. European Organization for Research and Treatment of Cancer Headquarters, Brussels, Belgium. 10. Division of Clinical Neurooncology, Department of Neurology and Center of Integrated Oncology (CIO), University of Bonn, Bonn, Germany. 11. Groupe Hôpital Pitié-Salpetrière, Paris, France. 12. Department of Advanced Home Care and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 13. Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. 14. Department of Neurosciences, Azienda Ospedaliera San Giovanni Addolorata, Roma, Italy. 15. Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland. 16. Neurology Clinic and National Centre for Tumour Diseases, University Hospital Heidelberg, Heidelberg, Germany; German Consortium of Translational Cancer Research (DKTK), Clinical Cooperation Unit Neurooncology, German Cancer Research Center, Heidelberg, Germany. 17. Department of Neurology and Brain Tumour Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands.
Abstract
OBJECTIVE: Prognostic value of health-related quality of life (HRQoL) data may be important to inform patients in clinical practice and to guide clinical decision-making. Our study investigated the added prognostic value of HRQoL for overall survival (OS) and progression-free survival (PFS) in a large heterogeneous sample of glioma patients, besides known prognostic factors. METHODS: We included individual baseline data from previously published randomised controlled trials (RCTs) in glioma patients in which HRQoL was assessed through the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BN20 questionnaires. Multivariable Cox regression models (stratified for newly diagnosed versus recurrent disease) were constructed, first with clinical variables (age, sex, tumour type, performance status, allocated treatment and extent of resection) only and subsequently with HRQoL variables added, separately for OS and PFS. The added prognostic value of HRQoL was calculated using C-indices. RESULTS: Baseline HRQoL and clinical data from 15 RCTs were included, comprising 5217 patients. In the model including both clinical and HRQoL variables, better cognitive and role functioning and less motor dysfunction were independently associated with longer OS, whereas better role and cognitive functioning, less nausea and vomiting and more appetite loss were independently associated with prolonged PFS. However, C-indices indicated only a small prognostic improvement of the models for OS and PFS when adding HRQoL to the clinical prognostic variables (+1.1% for OS and +.7% for PFS). CONCLUSION: Our findings demonstrate that several baseline HRQoL variables are independently prognostic for OS and PFS, yet the added value of HRQoL to the known clinical prognostic variables was small.
OBJECTIVE: Prognostic value of health-related quality of life (HRQoL) data may be important to inform patients in clinical practice and to guide clinical decision-making. Our study investigated the added prognostic value of HRQoL for overall survival (OS) and progression-free survival (PFS) in a large heterogeneous sample of gliomapatients, besides known prognostic factors. METHODS: We included individual baseline data from previously published randomised controlled trials (RCTs) in gliomapatients in which HRQoL was assessed through the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BN20 questionnaires. Multivariable Cox regression models (stratified for newly diagnosed versus recurrent disease) were constructed, first with clinical variables (age, sex, tumour type, performance status, allocated treatment and extent of resection) only and subsequently with HRQoL variables added, separately for OS and PFS. The added prognostic value of HRQoL was calculated using C-indices. RESULTS: Baseline HRQoL and clinical data from 15 RCTs were included, comprising 5217 patients. In the model including both clinical and HRQoL variables, better cognitive and role functioning and less motor dysfunction were independently associated with longer OS, whereas better role and cognitive functioning, less nausea and vomiting and more appetite loss were independently associated with prolonged PFS. However, C-indices indicated only a small prognostic improvement of the models for OS and PFS when adding HRQoL to the clinical prognostic variables (+1.1% for OS and +.7% for PFS). CONCLUSION: Our findings demonstrate that several baseline HRQoL variables are independently prognostic for OS and PFS, yet the added value of HRQoL to the known clinical prognostic variables was small.
Authors: Louis Garnier; Emilie Charton; Antoine Falcoz; Sophie Paget-Bailly; Dewi Vernerey; Marine Jary; François Ducray; Elsa Curtit Journal: Neurooncol Pract Date: 2020-11-11
Authors: Marijke B Coomans; Marthe C M Peeters; Johan A F Koekkoek; Jan W Schoones; Jaap Reijneveld; Martin J B Taphoorn; Linda Dirven Journal: Cancers (Basel) Date: 2020-11-24 Impact factor: 6.639
Authors: Mirjam Renovanz; Anne-Katrin Hickmann; Minou Nadji-Ohl; Naureen Keric; Elke Weimann; Christian Rainer Wirtz; Susanne Singer; Florian Ringel; Jan Coburger Journal: Support Care Cancer Date: 2020-02-14 Impact factor: 3.603