Cognitive function as a predictor of survival in patients with recurrent malignant glioma

Purpose: To determine the contribution of cognitive function in predicting the survival of patients with recurrent malignant brain tumors. Patients and Methods: A total of 80 patients with recurrent glioblastoma mu ltiforme or anaplastic astrocytoma were seen for baseline evaluations befor e beginning a phase I or phase II clinical trial. Each patient received a b attery of nine brief tests measuring cognitive function, ability to perform activities of daily living (ADLs), and quality of life (QOL). Tests were g iven monthly after treatment was begun. Results: Performance on a test of verbal memory was independently and stron gly related to survival after accounting for age, Karnofsky performance sta tus score, histology, and time since diagnosis. Models incorporating three of nine and all nine rests in the battery accounted for significantly more variance in survival than did the clinical variables alone. Measures of QOL and ADLs (bathing, feeding, and so on) were not independently related to s urvival, although they provide clinical information that is important for p atient care. Conclusion: These results indicate that a multifaceted assessment of cognit ion, QOL, and patient function is practical for brain tumor patients in cli nical trials and can provide information regarding the relative risks versu s benefits of new treatment regimens that supplements the information from the usual clinical variables. J Clin Oncol 18:646-650. (C) 2000 by American Society of Clinical Oncology.