Controlled rehabilitative and supportive care intervention trials in patients with high-grade gliomas and their caregivers: a systematic review

Abstract

BackgroundPatients diagnosed with high-grade gliomas experience a varying and complex symptom burden, and face a high mortality rate. As a consequence, patients with high-grade gliomas and their caregivers have imminent and changing rehabilitative and supportive care needs.ObjectivesTo give a detailed overview of non-pharmacological rehabilitative and supportive care interventions for patients with high-grade gliomas and/or their caregivers, and provide an appraisal of the methodological quality of these studies.MethodPubMed, Cumulative Index of Nursing and Allied Health Literature and Embase were searched for literature published from 1995 to May 2013. Data from eight studies were reviewed for substantive methods and results. Methodological quality was described and assessed using the scoring system for appraising mixed methods research and concomitantly appraising qualitative, quantitative and mixed methods primary studies in mixed study reviews.ResultsThe search yielded 914 unique publications, of which 9 were classified eligible for this review. There is preliminary evidence that cognitive group therapy improves memory skills in patients with high-grade gliomas, early physical training improves functional outcome and massage therapy reduces stress. Patients and caregivers found that telephone follow-up and a specialist nurse function was an effective and useful way to achieve information and support. Finally, psycho-education increased feelings of mastery among caregivers.ConclusionsAs evidence is beginning to emerge, there is a need for well-designed longitudinal and randomised controlled trials of non-pharmacological interventions in high-grade glioma patients and their caregivers in order to develop clinical guidelines for supportive and rehabilitative approaches in this unique population.

Health-related quality of life in patients with high-grade gliomas: a quantitative longitudinal study

“…The is found to be a strong independent predictor of survival [34]. Nevertheless, only a limited number of international intervention studies have investigated the possible benefit of physical training among HGG patients [35]. Maintaining independence for as long as possible is a priority of the patients [20] and early physical rehabilitation is recommended [36], but additional research is warranted in order to clarify the value of training in this group of patients.…”

European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma

“…40,42 There is limited evidence to suggest that early physical training, massage therapy, and ambulatory rehabilitation may improve functional outcome, reduce stress, and improve quality of life in patients with glioma. 44 Importantly, getting rehabilitation during radiotherapy does not appear to limit engagement with rehabilitation. Post-radiotherapy rehabilitation can lead to functional gains, some of which will persist at 6 months.…”

The feasibility of a brain tumour website

“…This underscores the need for supporting health-related quality of life (HRQOL) in patients with HGG and their caregivers (Boele et al, 2012). Despite the increasing evidence that patients with HGG have imminent and changing rehabilitative and supportive care needs (D'Angelo et al, 2008;Molassiotis et al, 2010;Sizoo et al, 2013;Walbert andKhan, 2014, Rooney et al, 2013;Halkett et al, 2010), only few rehabilitative and supportive care intervention studies have targeted this specific population and its caregivers (Piil et al, 2014b).…”