University Neurosurgical Centre Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden and The Hague, the Netherlands.
Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
Adv Exp Med Biol. 2023;1416:235-252. doi: 10.1007/978-3-031-29750-2_18.
Historically, largely due to the good prognosis for survival, there has been little attention paid to the possible impact of meningiomas and their treatment on health-related quality of life (HRQoL). However, in the last decade there has been increasing evidence that patients with intracranial meningiomas suffer from long-term decreases in their HRQoL. Compared with controls and normative data, meningioma patients have worse HRQoL scores both before and after intervention and continuing long term (even after >4 years of follow-up). Overall, surgery results in improvements in many aspects of HRQoL. The limited available studies investigating the impact of radiotherapy suggest that this type of treatment decreases HRQoL scores, especially in the long term. There is however only limited evidence on additional determinants of HRQoL. Patients with anatomically complex skull base meningiomas and severe comorbidities, including epilepsy, report the lowest HRQoL scores. Other tumor and sociodemographic characteristics have shown weak associations with HRQoL. Furthermore, about one-third of caregivers of meningioma patients report caregiver burden, warranting interventions to improve caregiver HRQoL. As antitumor interventions may not improve HRQoL scores to be comparable to those of the general population, more attention should be paid to the development of integrative rehabilitation and supportive care programs for meningioma patients.
从历史上看,由于生存预后良好,人们很少关注脑膜瘤及其治疗对健康相关生活质量(HRQoL)的可能影响。然而,在过去十年中,越来越多的证据表明,颅内脑膜瘤患者的 HRQoL 长期下降。与对照组和规范数据相比,脑膜瘤患者在干预前后以及长期(甚至在>4 年后的随访后)都存在较差的 HRQoL 评分。总体而言,手术可改善 HRQoL 的许多方面。为数不多的研究调查放疗对 HRQoL 的影响的研究表明,这种治疗会降低 HRQoL 评分,尤其是在长期内。然而,关于 HRQoL 的其他决定因素的证据有限。具有解剖结构复杂颅底脑膜瘤和严重合并症(包括癫痫)的患者报告 HRQoL 评分最低。其他肿瘤和社会人口统计学特征与 HRQoL 仅显示出微弱的关联。此外,约三分之一的脑膜瘤患者的护理人员报告存在护理人员负担,需要采取干预措施来提高护理人员的 HRQoL。由于抗肿瘤干预措施可能无法将 HRQoL 评分提高到与普通人群相当的水平,因此应更加关注脑膜瘤患者综合康复和支持性护理计划的制定。