Objective: Supportive care needs in glioma patients often remain unrecognized, and optimization in assessment is required. First, we aimed at assessing the support needed using a simple structured questionnaire. Second, we investigated the psychosocial burden and support requested from caregivers.Methods: Patients were assessed at three centers during their outpatient visits. They completed the Distress Thermometer (DT; score ≥ 6 indicated significant burden in brain tumor patients), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30+BN20, and the Patients' Perspective Questionnaire (PPQ) that assessed psychosocial distress as well as support requested and received by patients for specific domains (e.g., family, doctor, and mobile care). In each subgroup, patients' caregivers were assessed simultaneously by a questionnaire developed for the study. Multivariate backward logistic regressions were performed for investigating predictors of patients' request for support.Results: Assessments were conducted for 232 patients. Most patients (82%) had a high-grade glioma and a mean age of 52 years (range 20–87). The male to female ratio was 1.25:1. According to the PPQ results, 38% (87) of the patients felt depressed; 44% (103), anxious; and 39% (91), tense/nervous. Desired support was highest from doctors (59%) and psychologists (19%). A general request for support was associated with lower global health status (p = 0.03, odds ratio (OR) = 0.96, 95% CI: 0.92–0.99) according to EORTC QLQ-C30. Most of the assessed caregivers (n = 96) were life partners (64%; n = 61) who experienced higher distress than the corresponding patients (caregivers: 6.5 ± 2.5 vs. patients: 5.3 ± 2.4). When patients were on chemotherapy, caregivers indicated DT ≥ 6 significantly more frequently than patients themselves (p = 0.02).Conclusion: Our data showed that glioma patients and their caregivers were both highly burdened. The PPQ allowed us to evaluate the psychosocial support requested and perceived by patients, detect supportive care needs, and provide information at a glance. Patients in poorer clinical condition are at risk of having unmet needs. The caregivers' burden and unmet needs are not congruent with the patients' need for support. In particular, caregivers of patients on chemotherapy were more highly burdened than patients themselves.
Abstracts iii9NEURO-ONCOLOGY • MAY 2017 whether D2HG increases the electrical activity of neurons. Three cohorts of WHO grade II-IV gliomas, from separate institutions (total N=712), were retrospectively assessed for the presence of preoperative seizures. Such seizures were noted in 18-34% of IDH1 wild-type (IDH1 wt ) patients and in 59-74% of IDH1 mut patients (P<0.001). Multivariable analysis, including WHO grade, 1p/19q codeletion, and temporal lobe tumor location, showed that IDH1 mut was an independent correlate with seizures (OR=2.5, 95% CI=1.6-3.9, P<0.001). Furthermore, exogenous D2HG increased the synchronized firing rate of cultured rat cortical neurons by 400-600%, but was completely blocked by AP5, a selective NMDA antagonist. Our data therefore suggests that the D2HG product of IDH1 mut increases neuronal activity by mimicking the activity of glutamate on the NMDA receptor, and that this is the reason why IDH1 mut gliomas are more likely to cause seizures in patients. Our data has rapid translational implications for the personalized management of TAE, as targeted IDH1 mut inhibitors may improve antiepileptic therapy in patients with IDH1 mut gliomas. BACKGROUND: Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and loss of meaning or purpose in work. Among oncologists, burnout has been reported to be significantly higher in those focusing on one type of cancer. CNS tumors are highly aggressive tumors with very poor prognosis. Caring for patients with CNS tumors can be challenging, and may place neuro-oncology health care providers at risk for burnout. The goal of this study was to explore the incidence and associated factors for burnout in neuro-oncology health care professionals. METHODS: We are conducting an international survey of health care providers of all professions treating patients with CNS tumors. The survey includes questions on demographic, career and lifestyle features. In addition, the Maslach Burnout Inventory, a 22-item questionnaire considered the gold-standard tool for measuring professional burnout, was incorporated. RESULTS: Up to Nov 15 th 324 SNO members have participated in the survey (53% females, 45% neuro-oncologists). Preliminary results indicate that 30% subjectively reported experiencing burnout and 45% reported experiencing burnout in the past. Most of the participants were from the United States (70%). More than 70% of the participants reported working more than 50 hours per week, and 95% reported working from home. Nearly half of participants reported significant stress, and did not meet exercise and sleep recommendations for a healthy lifestyle. 55% considered their income not adequate for the time and effort they devote to their profession. CONCLUSION: Burnout among neuro-oncology health care providers is a common problem. Estimating the prevalence of burnout and associated risk factors is imperative for improving professional and personal satisfaction and patient care. Expanding survey participation worldwide is needed to better u...
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