Quality of life after surgery for lower grade gliomas

Heffernan, Anne E.; Wu, Yilun; Benz, Luke S.; Verhaak, Roel G. W.; Kwan, Bethany M.; Claus, Elizabeth B.

doi:10.1002/cncr.34980

Cited by 4 publications

(1 citation statement)

References 69 publications

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“…However, these comparative results should not be understood to imply a low humanistic burden in low-grade glioma in absolute terms – impaired physical, cognitive, and emotional functioning are observed in 35%, 50%, and 48% of patients, respectively, within 5 years of treatment ( 72 ). Physical, cognitive, and emotional functioning and QoL in patients with low-grade glioma remains below age-matched general population levels ( 73 ).…”

Section: Burdenmentioning

confidence: 99%

High costs, low quality of life, reduced survival, and room for improving treatment: an analysis of burden and unmet needs in glioma

Pöhlmann,

Weller,

Marcellusi

et al. 2024

Front. Oncol.

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Gliomas are a group of heterogeneous tumors that account for substantial morbidity, mortality, and costs to patients and healthcare systems globally. Survival varies considerably by grade, histology, biomarkers, and genetic alterations such as IDH mutations and MGMT promoter methylation, and treatment, but is poor for some grades and histologies, with many patients with glioblastoma surviving less than a year from diagnosis. The present review provides an introduction to glioma, including its classification, epidemiology, economic and humanistic burden, as well as treatment options. Another focus is on treatment recommendations for IDH-mutant astrocytoma, IDH-mutant oligodendroglioma, and glioblastoma, which were synthesized from recent guidelines. While recommendations are nuanced and reflect the complexity of the disease, maximum safe resection is typically the first step in treatment, followed by radiotherapy and/or chemotherapy using temozolomide or procarbazine, lomustine, and vincristine. Immunotherapies and targeted therapies currently have only a limited role due to disappointing clinical trial results, including in recurrent glioblastoma, for which the nitrosourea lomustine remains the de facto standard of care. The lack of treatment options is compounded by frequently suboptimal clinical practice, in which patients do not receive adequate therapy after resection, including delayed, shortened, or discontinued radiotherapy and chemotherapy courses due to treatment side effects. These unmet needs will require significant efforts to address, including a continued search for novel treatment options, increased awareness of clinical guidelines, improved toxicity management for chemotherapy, and the generation of additional and more robust clinical and health economic evidence.

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Section: Burdenmentioning

confidence: 99%

High costs, low quality of life, reduced survival, and room for improving treatment: an analysis of burden and unmet needs in glioma

Pöhlmann,

Weller,

Marcellusi

et al. 2024

Front. Oncol.

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“It changes everything”: Understanding how people experience the impact of living with a lower-grade glioma

Rimmer,

Balla,

Dutton

et al. 2024

Neuro-Oncology Practice

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Background Quantitative studies show people living with a lower-grade glioma (LGG) often report low health-related quality-of-life. However, it is unclear how this impact is experienced; resulting supportive care needs are also poorly understood. We explored how people experience the impact of living long-term with an LGG, to help identify potential supportive care needs. Methods We conducted semi-structured interviews with a diverse group of people with LGG (n=28) across the United Kingdom, who had completed primary treatment (male n=16, female n=12, mean age 54.6 years, mean time since diagnosis 8.7 years). Interviews were transcribed and inductive thematic analysis was conducted. Results Four themes relating to the impact experiences of people with LGG were generated: ‘Emotional response to the diagnosis’, ‘Living with the ‘What ifs’’, ‘Changing relationships’, and ‘Faltering independence’. These reflect participants’ experiences with symptoms (e.g. fatigue, seizures) and impairments (e.g. motor dysfunction, cognitive deficits), and how these, in turn, drive impacts on daily living (including on work, relationships, social activities and transport). Participants spoke about their experiences with profound emotion throughout. Conclusions People with LGG can experience wide-ranging everyday impacts and may have extensive supportive care needs. This study highlights how this impact is experienced and what it means to people with LGG. Best practice suggestions for conducting comprehensive needs assessments tailored to those with LGG, and development of personalised plans to meet those needs, would be a critical step to ensure that people with LGG are best supported in living with their condition.

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Glioma resource outreach with support: A program to identify and initiate supportive care interventions for unmet needs among adult lower-grade glioma patients

Garcia Fox,

Chukwueke,

Sannes

et al. 2024

Neuro-Oncology Practice

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Background Lower grade (WHO grade 2-3) gliomas typically affect young and middle-aged adults and exhibit isocitrate dehydrogenase (IDH) mutations. For such patients, symptoms related to the tumor and associated treatment contribute to morbidity and erode quality of life. With improved treatment, better understanding of these effects over time is critically needed. Existing data characterizing unmet needs of lower grade glioma patients is limited and little consensus exists on addressing these needs in clinical practice. Methods In order to better identify and address unmet needs of lower grade glioma patients, focus groups among patients and caregivers were initially conducted among patients treated at a single academic center. A semi-structured interview guide to comprehensively understand unmet needs was then developed. Each patient defined unmet need was categorized into domains through qualitative content analysis. In parallel, a database of established local and regional community-based resources was established, and a dedicated resource specialist provided patient-specific referrals and follow-up. Results 85 patients were interviewed. Median age was 41 years and the median time from tumor diagnosis was 63 months. Approximately 68% had a WHO grade 2 tumor and 60% were off therapy. Qualitative analysis of interview content identified five overarching domains of unmet need: Psychosocial; Neurologic/Cognitive; Lifestyle; Financial; and Other Medical. At least one unmet need was identified by 71% of participants and the most common domains were Psychosocial (40.7%) and Lifestyle (34.9%). Conclusion Our program begins to address frequently unmet survivorship needs of lower grade glioma patients that spanned five major domains. Further research aimed to better define and address unmet needs among these patients is warranted.

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Quality of life after surgery for lower grade gliomas

Cited by 4 publications

References 69 publications

High costs, low quality of life, reduced survival, and room for improving treatment: an analysis of burden and unmet needs in glioma

High costs, low quality of life, reduced survival, and room for improving treatment: an analysis of burden and unmet needs in glioma

“It changes everything”: Understanding how people experience the impact of living with a lower-grade glioma

Glioma resource outreach with support: A program to identify and initiate supportive care interventions for unmet needs among adult lower-grade glioma patients

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