Symptom clusters in newly diagnosed glioma patients: which symptom clusters are independently associated with functioning and global health status?

Abstract

BackgroundSymptom management in glioma patients remains challenging, as patients suffer from various concurrently occurring symptoms. This study aimed to identify symptom clusters and examine the association between these symptom clusters and patients’ functioning.MethodsData of the CODAGLIO project was used, including individual patient data from previously published international randomized controlled trials (RCTs) in glioma patients. Symptom prevalence and level of functioning were assessed with European Organisation for Research and Treatment of Cancer (EORTC) quality of life QLQ-C30 and QLQ-BN20 self-report questionnaires. Associations between symptoms were examined with Spearman correlation coefficients and partial correlation networks. Hierarchical cluster analyses were performed to identify symptom clusters. Multivariable regression analyses were performed to determine independent associations between the symptom clusters and functioning, adjusted for possible confounders.ResultsIncluded in the analysis were 4307 newly diagnosed glioma patients from 11 RCTs who completed the EORTC questionnaires before randomization. Many patients (44%) suffered from 5–10 symptoms simultaneously. Four symptom clusters were identified: a motor cluster, a fatigue cluster, a pain cluster, and a gastrointestinal/seizures/bladder control cluster. Having symptoms in the motor cluster was associated with decreased (≥10 points difference) physical, role, and social functioning (betas ranged from −11.3 to −15.9, all P < 0.001), independent of other factors. Similarly, having symptoms in the fatigue cluster was found to negatively influence role functioning (beta of −12.3, P < 0.001), independent of other factors.ConclusionsTwo symptom clusters, the fatigue and motor cluster, were frequently affected in glioma patients and were found to independently have a negative association with certain aspects of patients’ functioning as measured with a self-report questionnaire.

Postoperative Long-Term Independence Among the Elderly With Meningiomas: Function Evolution, Determinant Identification, and Prediction Model Development

“…Our study demonstrated the postoperative long-term independence status varied considerably across meningioma patients, especially patients with preoperative KPS equal to 80 and 70 have obvious polarization trends in postoperative long-term independence. Then, similar to what has been reported in a previous study about glioma (30), we have found that fatigue, memory impairment, motor dysfunction, and communication deficits were consistently highly correlated with long-term loss of independence in elderly meningioma patients. Finally, we identified several independent risk factors to develop and internally validate a prediction model for postoperative long-term loss of independence in the elderly with meningioma.…”

Sleep disturbance in primary brain tumor: prevalence, risk factors, and patient preferences

“…For example, one study found that 89% of patients with PBT who were categorized as having insomnia endorsed fatigue [ 31 , 33 ]. These findings are clinically relevant given that fatigue is known to adversely affect both the quality of life (e.g., disrupting mood) and functioning of PBT patients [ 34 , 35 ]. Similarly, the association between corticosteroids use and sleep disturbance has been shown in previous investigations [ 31 ].…”

Implementation, relevance, and virtual adaptation of neuro-oncological tumor boards during the COVID-19 pandemic: a nationwide provider survey

“…Between these different disciplines, a leadership role for patients and caregivers is needed to ensure fixed contact partners and a managing/coordinating department. Especially patients with primary brain tumors as well as their caregivers might need a designated site for contact due to the high amount of psycho-social distress and impairment in physical and cognitive functioning [28]. Neuro-oncological neurologists, as representatives of a non-interventional discipline, may be predisposed to this role.…”