The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands.
J Clin Oncol. 2011 Nov 20;29(33):4430-5. doi: 10.1200/JCO.2011.35.5750. Epub 2011 Oct 17.
To investigate the generic and condition-specific health-related quality of life (HRQL) of patients with low-grade glioma (LGG).
A total of 195 patients with LGG, which was diagnosed, on average, 5.6 years before the study, were compared with 100 patients with hematologic (non-Hodgkin's) lymphoma and chronic lymphatic leukemia cancer (NHL/CLL) and 205 general population controls who were comparable with patients with LGG at the group level for age, sex, and education (healthy controls). Generic HRQL was assessed with the Short Form-36 (SF-36) Health Survey, and condition-specific HRQL was assessed with the Medical Outcomes Study cognitive function questionnaire and the European Organisation for Research and Treatment of Cancer brain cancer module. Objective neurocognitive functioning was assessed with a standardized battery of neuropsychological tests.
No statistically significant differences were observed between patients with LGG and patients with NHL/CLL in SF-36 scores. Patients with LGG scored significantly lower than healthy controls on six of eight scales and on the mental health component score of the SF-36. Approximately one quarter of patients with LGG reported serious neurocognitive symptoms. Female sex, epilepsy burden, and number of objectively assessed neurocognitive deficits were associated significantly with both generic and condition-specific HRQL. Clinical variables, including the time since diagnosis, tumor lateralization, extent of surgery, and radiotherapy, did not show a consistent relationship with HRQL.
Patients with LGG experienced significant problems across a broad range of HRQL domains, many of which were not condition-specific. However, the neurocognitive deficits and epilepsy that were relatively prevalent among patients with LGG were associated with negative HRQL outcomes and, thus, contributed additionally to the vulnerability of this population of patients with cancer.
研究低级别胶质瘤(LGG)患者的通用和特定疾病健康相关生活质量(HRQL)。
共有 195 名 LGG 患者(平均在研究前 5.6 年被诊断)与 100 名血液学(非霍奇金淋巴瘤和慢性淋巴细胞白血病)患者和 205 名普通人群对照组进行比较。LGG 患者在年龄、性别和教育程度(健康对照组)上与 LGG 患者群体相当。使用 36 项简短健康调查问卷(SF-36)评估通用 HRQL,使用医学结局研究认知功能问卷和欧洲癌症研究与治疗组织脑癌模块评估特定疾病 HRQL。使用标准化神经心理学测试套件评估客观神经认知功能。
LGG 患者和 NHL/CLL 患者在 SF-36 评分上无统计学差异。LGG 患者在八个量表中的六个量表和 SF-36 的心理健康分量表上的得分明显低于健康对照组。大约四分之一的 LGG 患者报告存在严重的神经认知症状。女性、癫痫负担和客观评估的神经认知缺陷数量与通用和特定疾病 HRQL 显著相关。临床变量,包括诊断时间、肿瘤侧化、手术范围和放疗,与 HRQL 没有一致的关系。
LGG 患者在广泛的 HRQL 领域存在显著问题,其中许多问题不是特定于疾病的。然而,在 LGG 患者中相对普遍的神经认知缺陷和癫痫与负面 HRQL 结果相关,因此进一步增加了这一癌症患者群体的脆弱性。