Literature DB >> 34277024

Living with a central nervous system (CNS) tumor: findings on long-term survivorship from the NIH Natural History Study.

James L Rogers1, Elizabeth Vera1, Alvina Acquaye1, Nicole Briceno1, Varna Jammula1, Amanda L King1, Heather Leeper1, Martha M Quezado2, Javier Gonzalez Alarcon1, Lisa Boris3, Eric Burton1, Orieta Celiku1, Anna Choi1, Alexa Christ1, Sonja Crandon1, Ewa Grajkowska1, Nicole Leggiero4, Nicole Lollo1, Marta Penas-Prado1, Jennifer Reyes1, Christine Siegel3, Brett J Theeler5, Michael Timmer1, Kathleen Wall3, Jing Wu1, Kenneth Aldape2, Mark R Gilbert1, Terri S Armstrong1.   

Abstract

BACKGROUND: Primary central nervous system (CNS) tumors are often associated with high symptom burden and a poor prognosis from the time of diagnosis. The purpose of this study is to describe patient-reported outcomes (PRO) data from long-term survivors (LTS; ≥5-year survival post-diagnosis).
METHODS: Clinical/treatment/molecular characteristics and PROs (symptom burden/interference (MDASI-BT/SP), perceived cognition (Neuro-QoL), anxiety/depression (PROMIS), and general health status (EQ-5D-3L)) were collected on 248 adult LTS between 9/2016 and 8/2019. Descriptive statistics and regression analysis were used to report results.
RESULTS: Participants had a median age of 47 years (19-82) and were primarily White (83%) males (51%) with high-grade tumors (59%) and few mutations. Forty-two percent of the 222 brain tumor LTS reported no moderate-to-severe symptoms, whereas 45% reported three or more; most common symptoms were fatigue (40%), difficulty remembering (29%), and drowsiness (28%). Among spine tumor LTS (n = 42), nearly half reported moderate-to-severe weakness, pain, fatigue, and numbness/tingling, with 72% experiencing activity-related interference. Severe anxiety, depression, and cognitive symptoms were reported in up to 23% of the sample. Brain tumor LTS at higher risk for severe symptoms were more likely to be young, unemployed, and have poor KPS (Karnofsky Performance Status), whereas high symptom-risk spinal cord tumor LTS had poor KPS and received any tumor treatment.
CONCLUSIONS: Findings indicate LTS fall into distinct cohorts with no significant symptoms or very high symptom burden, regardless of tumor grade or mutational profile. These LTS data demonstrate the need for survivorship care programs and future studies to explore the symptom trajectory of all CNS tumor patients for prevention and early interventions. Published by Oxford University Press 2021.

Entities:  

Keywords:  CNS tumor; long-term survivor; patient-reported outcomes; survivorship; symptom burden

Year:  2021        PMID: 34277024      PMCID: PMC8278352          DOI: 10.1093/nop/npab022

Source DB:  PubMed          Journal:  Neurooncol Pract        ISSN: 2054-2577


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