EFFECT OF NEUROLOGICAL DYSFUNCTION ON HEALTH-RELATED QUALITY-OF-LIFE IN PATIENTS WITH HIGH-GRADE GLIOMA

The purpose of the study was to assess health-related quality of life (HQL) in patients with high-grade malignant glioma of the brain. The E ORTC core Quality of Life Questionaire (QLQ-C30) and a Brain Cancer Mo dule (BCM20) were administered at baseline and several weeks later (fo llow-up) to 105 patients with either recently-diagnosed (n = 41) or re current (n = 64) malignant glioma. In addition, the attending neurolog ists completed a standard neurological examination, a modified Barthel Activities of Daily Living Index (BADLI) and the Karnofsky Performanc e Scale (KPS). In a preliminary step, the QLQ-C30 was found to have ac ceptable reliability (internal consistency and test-retest reliability ). Newly-diagnosed patients and those with a KPS of 80-100 had signifi cantly better physical, role and cognitive functioning and global qual ity of life with less fatigue, visual disorder, motor dysfunction, com munication deficit, weakness of both legs and trouble controlling the bladder than did those with recurrent disease and those with a KPS of 50-70. Similarly, those capable of independent activities of daily liv ing, as reported on the BADLI, had higher functioning scores and less fatigue than did those who were not independent. Patients with dysphas ia, mental confusion or motor deficit on neurological examination repo rted significantly lower levels of physical, role, cognitive, emotiona l and social functioning and global quality of life than did patients not having these difficulties. They also had significantly more sympto ms. In patients with deteriorating neurological status between baselin e and follow-up, there was a marked decline in cognitive, physical, ro le, emotional and social functioning and global quality of life and an increase in fatigue. Thus, there are significant differences in HQL b etween patients with newly-diagnosed and recurrent brain cancer and be tween patients with differing KPS and BADLI scores. In addition, the H QL scores provide details not provided by the KPS and the BADLI. Deter ioration in neurological function is accompanied by significant deteri oration in a range of HQL domains and in global quality of life.