Health-related quality of life in adults with low-grade gliomas: a systematic review

Abstract

Purpose Low-grade glioma (LGG) patients may face health-related quality-of-life (HRQoL) impairments, due to the tumour, treatment and associated side-effects and prospects of progression. We systematically identified quantitative studies assessing HRQoL in adult LGG patients, for: aspects of HRQoL impacted; comparisons with non-cancer controls (NCC) and other groups; temporal trends; and factors associated with HRQoL. Methods MEDLINE, CINAHL, Embase, PubMed, and PsycINFO were systematically searched from inception to 14th September 2021. Following independent screening of titles and abstracts and full-texts, population and study characteristics, and HRQoL findings were abstracted from eligible papers, and quality appraised. Narrative synthesis was conducted. Results Twenty-nine papers reporting 22 studies (cross-sectional, n = 13; longitudinal, n = 9) were identified. Papers were largely good quality, though many excluded patients with cognitive and communication impairments. Comparators included high-grade gliomas (HGG) (n = 7); NCCs (n = 6) and other patient groups (n = 3). Nineteen factors, primarily treatment (n = 8), were examined for association with HRQoL. There was substantial heterogeneity in HRQoL instruments used, factors and aspects of HRQoL assessed and measurement timepoints. HRQoL, primarily cognitive functioning and fatigue, in adult LGG patients is poor, and worse than in NCCs, though better than in HGG patients. Over time, HRQoL remained low, but stable. Epilepsy/seizure burden was most consistently associated with worse HRQoL. Conclusion LGG patients experience wide-ranging HRQoL impairments. HRQoL in those with cognitive and communication impairments requires further investigation. These findings may help clinicians recognise current supportive care needs and inform types and timings of support needed, as well as inform future interventions.

Quality of life after surgery for lower grade gliomas

“…As with symptoms, these findings may indicate that physical, social, and emotional health improve with time for patients with LGG, although it is also likely that those experiencing the most significant reductions in QOL may be less willing or able to participate in research. Several longitudinal studies have suggested that QOL scores remain consistently low and change little with increasing time since diagnosis and treatment 36 . However, substantial loss to follow‐up and failure to account for tumor progression or recurrence in these studies highlight a need for more research on long‐term outcomes for patients with LGG.…”

Understanding language and cognition after brain surgery – Tumour grade, fine‐grained assessment tools and, most of all, individualized approach

“…Language and cognition have been widely described as key factors of brain tumour patients' quality of life and survival (Rimmer et al, 2023; Salans et al, 2021). Within cognition, better performance in executive functioning, processing speed, working memory (Boele et al, 2014), and divided attention (Svedung Wettervik et al, 2022) have been associated with better health‐related quality of life.…”

Neurorehabilitation in brain tumours: evidences and suggestions for spreading of knowledge and research implementation

“…These problems have the potential to impact physical and mental health and often lead to a reduction of the person's function, autonomy in the activities of daily life and social participation, decreasing health-related quality of life (HRQoL) [15,16,17 ▪ ,18 ▪▪ ]. Moreover, diagnosis of BT can further have significant costs and socioeconomic implications and increase demand for healthcare, social, and vocational services, and caregiver burden [19,20,21,22 ▪ ].…”