Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
Department of Neurology, Haaglanden Medical Center, Den Haag, the Netherlands.
Neuro Oncol. 2022 Dec 1;24(12):2159-2169. doi: 10.1093/neuonc/noac097.
Maintenance of functioning and well-being during the progression-free survival (PFS) period is important for glioma patients. This study aimed to determine whether health-related quality of life (HRQoL) can be maintained during progression-free time, and factors associated with HRQoL deterioration in this period.
We included longitudinal HRQoL data from previously published clinical trials in glioma. The percentage of patients with stable HRQoL until progression was determined per scale and at the individual patient level (i.e. considering all scales simultaneously). We assessed time to a clinically relevant deterioration in HRQoL, expressed in deterioration-free survival and time-to-deterioration (the first including progression as an event). We also determined the association between sociodemographic and clinical factors and HRQoL deterioration in the progression-free period.
Five thousand five hundred and thirty-nine patients with at least baseline HRQoL scores had a median time from randomization to progression of 7.6 months. Between 9-29% of the patients deteriorated before disease progression on the evaluated HRQoL scales. When considering all scales simultaneously, 47% of patients deteriorated on ≥1 scale. Median deterioration-free survival period ranged between 3.8-5.4 months, and median time-to-deterioration between 8.2-11.9 months. For most scales, only poor performance status was independently associated with clinically relevant HRQoL deterioration in the progression-free period.
HRQoL was maintained in only 53% of patients in their progression-free period, and treatment was not independently associated with this deterioration in HRQoL. Routine monitoring of the patients' functioning and well-being during the entire disease course is therefore important, so that interventions can be initiated when problems are signaled.
在无进展生存期（PFS）期间保持功能和健康状态对于脑胶质瘤患者很重要。本研究旨在确定在无进展期间是否可以维持健康相关生活质量（HRQoL），以及与该期间 HRQoL 恶化相关的因素。
我们纳入了先前发表的脑胶质瘤临床试验中的纵向 HRQoL 数据。根据每个量表和个体患者水平（即同时考虑所有量表）确定直到进展为止稳定 HRQoL 的患者比例。我们评估了 HRQoL 临床相关恶化的时间，用无恶化生存和恶化时间（第一个包括进展作为事件）表示。我们还确定了社会人口统计学和临床因素与无进展期间 HRQoL 恶化之间的关联。
5539 名至少有基线 HRQoL 评分的患者从随机分组到进展的中位时间为 7.6 个月。在评估的 HRQoL 量表中，有 9-29%的患者在疾病进展前恶化。当同时考虑所有量表时，有 47%的患者恶化了≥1 个量表。无恶化生存期间的中位数范围为 3.8-5.4 个月，恶化时间的中位数为 8.2-11.9 个月。对于大多数量表，只有较差的表现状态与无进展期间的临床相关 HRQoL 恶化独立相关。
只有 53%的患者在无进展期间维持了 HRQoL，治疗与 HRQoL 恶化无关。因此，在整个疾病过程中定期监测患者的功能和健康状况非常重要，以便在出现问题时可以进行干预。
