QUALITY-OF-LIFE IN BRAIN-TUMOR PATIENTS

With the aim of evaluating the quality of life (QL) of 101 brain tumor patients, a multidimensional approach was adopted, using the Function al Living Index - Cancer (FLIC) as a global measure of well-being, the Karnofsky Performance Scale (KPS) and the Index of Independence in Ac tivity of Daily Living (ADL) as indices of physical and functional dim ensions, the State-Trait Anxiety Inventory (STAI) and the Self-Rating Depression Scale (SRDS) for psychological assessment, and neuropsychol ogical tests for abstract reasoning, attention, memory and frontal lob e functions. The patients were grouped on the grounds of disease stage and treatment. The FLIC and KPS ratings increased from the patients w ho had just undergone surgery to patients who were disease-free after completing chemotherapy and radiotherapy, thus showing that the QL may improve during the disease despite aggressive treatments, providing t here is no tumor recurrence. However, only the FLIC consistently discr iminated the patients' stratification. The ADL revealed no between-gro up differences, whereas the STAI and SRDS revealed the presence of emo tional troubles at the beginning and at the end of treatment. Cognitiv e impairment was more serious after radiotherapy and chemotherapy, as well as in patients with tumor recurrence. The FLIC significantly corr elated with all of the other scales used, showing that it is useful in summarizing both the physical and psychosocial impairment of brain tu mor patients. Of the pathological variables, a tumor location in the a nterior right hemisphere or diencephalon was associated with high FLIC ratings, may be due to the minor cognitive impairment observed in pat ients with these tumor sites. Of the demographic variables, the level of education was associated with high FLIC ratings, thus highlighting the role of psychosocial environment in improving the QL. The use of a multidimensional approach or a global index of well-being that also r eflects psychosocial and cognitive aspects proved to be more appropria te than traditional functional instruments (such as the KPS) in assess ing the QL of brain tumor patients and in detecting the extent of the disease.