Effect of neurological dysfunction on health-related quality of life in patients with high-grade glioma

The purpose of the study was to assesshealth-related quality of life (HQL) in patients withhigh-grade malignant glioma of the brain. The EORTCcore Quality of Life Questionaire (QLQ-C30) and aBrain Cancer Module (BCM20) were administered at baselineand several weeks later (follow-up) to 105 patientswith either recently-diagnosed (n=41) or recurrent(n=64) malignant glioma. In addition, theattending neurologists completed a standard neurological examination, amodified Barthel Activities of Daily Living Index (BADLI)and the Karnofsky Performance Scale (KPS). In apreliminary step, the QLQ-C30 was found to haveacceptable reliability (internal consistency and test-retest reliability). Newly-diagnosedpatients and those with a KPS of 80–100had significantly better physical, role and cognitive functioningand global quality of life with less fatigue,visual disorder, motor dysfunction, communication deficit, weakness ofboth legs and trouble controlling the bladder thandid those with recurrent disease and those witha KPS of 50–70. Similarly, those capable ofindependent activities of daily living, as reported onthe BADLI, had higher functioning scores and lessfatigue than did those who were not independent.Patients with dysphasia, mental confusion or motor deficiton neurological examination reported significantly lower levels ofphysical, role, cognitive, emotional and social functioning andglobal quality of life than did patients nothaving these difficulties. They also had significantly moresymptoms. In patients with deteriorating neurological status betweenbaseline and follow-up, there was a marked declinein cognitive, physical, role, emotional and social functioningand global quality of life and an increasein fatigue. Thus, there are significant differences inHQL between patients with newly-diagnosed and recurrent braincancer and between patients with differing KPS andBADLI scores. In addition, the HQL scores providedetails not provided by the KPS and theBADLI. Deterioration in neurological function is accompanied bysignificant deterioration in a range of HQL domainsand in global quality of life.