Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands.
J Neurooncol. 2020 Jan;146(2):293-301. doi: 10.1007/s11060-019-03373-y. Epub 2020 Jan 1.
Little is known about the symptoms glioma patients experience in the year before diagnosis, either or not resulting in health care usage. This study aimed to determine the incidence of symptoms glioma patients experienced in the year prior to diagnosis, and subsequent visits to a general practitioner (GP).
Glioma patients were asked to complete a 30-item study-specific questionnaire focusing on symptoms they experienced in the 12 months before diagnosis. For each indicated symptom, patients were asked whether they consulted the GP for this issue.
Fifty-nine patients completed the questionnaires, 54 (93%) with input of a proxy. The median time since diagnosis was 4 months (range 1-12). The median number of symptoms experienced in the year before diagnosis was similar between gliomas with favourable and poor prognosis, i.e. 6 (range 0-24), as were the five most frequently mentioned problems: fatigue (n = 34, 58%), mental tiredness (n = 30, 51%), sleeping disorder (n = 24, 41%), headache (n = 23, 39%) and stress (n = 20, 34%). Twenty-six (44%) patients visited the GP with at least one issue. Patients who did consult their GP reported significantly more often muscle weakness (11 vs 3, p = 0.003) than patients who did not, which remained significant after correction for multiple testing, which was not the case for paralysis in hand/leg (10 vs 4), focussing (11 vs 6) or a change in awareness (9 vs 4).
Glioma patients experience a range of non-specific problems in the year prior to diagnosis, but only patients who consult the GP report more often neurological problems.
对于胶质瘤患者在诊断前一年经历的症状，无论是导致还是不导致医疗保健的使用，我们知之甚少。本研究旨在确定胶质瘤患者在诊断前一年经历的症状发生率，以及随后就诊于全科医生（GP）的情况。
要求胶质瘤患者完成一份 30 项的研究特定问卷，重点关注他们在诊断前 12 个月经历的症状。对于每个症状，患者被询问是否因该问题就诊于 GP。
59 名患者完成了问卷，其中 54 名（93%）由代理人完成。自诊断以来的中位时间为 4 个月（范围 1-12）。在诊断前一年经历的症状中位数在预后良好和预后不良的胶质瘤之间相似，即 6 个（范围 0-24），最常提到的五个问题也是如此：疲劳（n=34，58%）、精神疲劳（n=30，51%）、睡眠障碍（n=24，41%）、头痛（n=23，39%）和压力（n=20，34%）。26 名（44%）患者因至少一个问题就诊于 GP。与未就诊的患者相比，就诊于 GP 的患者报告的肌肉无力明显更多（11 例比 3 例，p=0.003），但在校正多重检验后，这并不成立，而手部/腿部瘫痪（10 例比 4 例）、注意力集中（11 例比 6 例）或意识改变（9 例比 4 例）则不然。
胶质瘤患者在诊断前一年会经历一系列非特异性问题，但只有就诊于 GP 的患者更常报告神经问题。
