Health-related quality of life and psychological functioning in patients with primary malignant brain tumors: a systematic review of clinical, demographic and mental health factors

Abstract

Background The impact of primary malignant brain tumors on patient quality of life and psychological functioning is poorly understood, limiting the development of an evidence base for supportive interventions. We conducted a thorough systematic review and quality appraisal of the relevant literature to identify correlates of health-related quality of life (HRQoL) and psychological functioning (depression, anxiety and distress) in adults with primary malignant brain tumors. Method Twenty-three articles met predefined inclusion criteria from a pool of peer-reviewed literature published between January 1984 and July 2015 (N = 2407). Methodological quality of included studies was assessed using an adapted version of the Newcastle-Ottawa Scale. Results The overall methodological quality of the literature was moderate. Factors relating consistently with HRQoL and/or psychological functioning were cognitive impairment, corticosteroid use, current or previous mental health difficulties, fatigue, functional impairment, performance status and motor impairment. Conclusions Practitioners should remain alert to the presence of these factors as they may indicate patients at greater risk of poor HRQoL and psychological functioning. Attention should be directed towards improving patients' psychological functioning and maximizing functional independence to promote HRQoL. We outline several areas of future research with emphasis on improved methodological rigor.

Patient‐reported health‐related quality of life outcomes in supportive‐care interventions for adults with brain tumors: A systematic review

“…Studies were included in the review if they included: Participants: adults (18 years of age or older) diagnosed with a brain tumor, primary, or metastatic; Interventions: supportive‐care, defined as a psychosocial/behavioral, pharmacological, complementary, or alternative interventions; Comparisons: waitlist, placebo, usual‐care, treatment‐as‐usual, or standard‐of‐care control conditions; Outcomes: patient‐reported HRQoL (often erroneously labeled as QoL) as a primary or secondary outcome; Time: published any time before April 2018; and Study Design: Randomized controlled trials.…”

“…Brian tumors are unique compared with other cancers because progressive neurological deterioration can lead to personality changes and cognitive and functional decline, which can magnify the impact on quality of life and health‐related quality of life (HRQoL) specifically . HRQoL has been defined as “a multi‐dimensional concept that includes domains related to physical, mental, emotional, and social functioning.” Primary and metastatic brain tumors, as well as their treatment sequelae, often greatly negatively impact patients' HRQoL (for a narrative review of the status of HRQoL among primary brain tumor patients, including a discussion about the difficult trade‐off between quantity and quality of life, see Dirven et al). The disease and treatment trajectories for patients with benign, low‐grade, high‐grade, and metastatic brain tumors are highly heterogeneous and can impact HRQoL differently.…”

“…7 HRQoL has been defined as "a multi-dimensional concept that includes domains related to physical, mental, emotional, and social functioning." 8 Primary and metastatic brain tumors, as well as their treatment sequelae, often greatly negatively impact patients' HRQoL 7,[9][10][11] (for a narrative review of the status of HRQoL among primary brain tumor patients, including a discussion about the difficult trade-off between quantity and quality of life, see Dirven et al 10 ). The disease and treatment trajectories for patients with benign, low-grade, high-grade, and metastatic brain tumors are highly heterogeneous and can impact HRQoL differently.…”

Can Multidisciplinary Inpatient and Outpatient Rehabilitation Provide Sufficient Prevention of Disability in Patients with a Brain Tumor?—A Case-Series Report of Two Programs and A Prospective, Observational Clinical Trial

“…Patients in the two types of rehabilitation programs were enrolled according to the study criteria and functional independence (when patients required help in most everyday activities and could not reach the rehabilitation hospital with their families, they were admitted to the inpatient rehabilitation center). Patients with BT have varying degrees of functional and psychological impairment because of factors relating to the tumor or to the treatment they received [6][7][8]. The study patients with statistically significant impairment manifested a decrease in physical functioning measurements such as BI (below 14 points) or BBS (under 40 points), FIM (below 90 points) and their subscales, and without social cognition and communication were enrolled in the inpatient center.…”

“…Many of those are connected with neurological deficits, leading to behavioral, cognitive, and physical dysfunctions [3]. In addition, BTs and their onco-therapy can have a negative impact on patients' QoL including their family life, work, and self-sufficiency, which is associated with significant costs and socioeconomic implications like increased requirements for health care, and social care services [5][6][7][8]. As these difficulties have complex manifestations, multidisciplinary expertise is necessary to evaluate the influence of each variable in the rehabilitation plan in order to provide appropriate support.…”