Fabbro Michel, Thomaso Muriel, Darlix Amélie, Perotin Virginie, Gallay Caroline, Charissoux Marie, Granier Anne-Chantal, Bouazza Nabila, Champoiral Patrice, Coutant Louise, Jarlier Marta, Guerdoux Estelle
Department of Medical Oncology, Montpellier Cancer Institute, University of Montpellier, Montpellier, France.
Palliative and Supportive Care Department, Montpellier Cancer Institute, University of Montpellier, Montpellier, France.
Neurooncol Adv. 2025 Mar 27;7(1):vdaf064. doi: 10.1093/noajnl/vdaf064. eCollection 2025 Jan-Dec.
Early palliative care improves the quality of life (QoL) and survival in patients with cancer; however, its effects in patients with glioblastoma remain unclear. The GLIOSUPPORT study assessed the feasibility (adherence; primary objective) of an early palliative care program integrated into the standard glioblastoma care pathway. Secondary objectives included the description of the patients' characteristics, QoL, and neuropsychological changes over time, end-of-life decisions, end-of-life treatments, and family carers' perceptions/experiences.
This interventional, prospective, longitudinal, feasibility study was conducted in a French comprehensive cancer center. Thirty-five patients with newly diagnosed glioblastoma were required to reach an adherence rate of 60%. Adherence was defined as going to 3 palliative care visits scheduled every 12 weeks. Baseline characteristics were compared in patients who did and did not adhere to the palliative care program. Minimal clinically important differences and cut-offs were used to quantify QoL changes.
The adherence rate was 60% (95% CI [42.1%-76.1%]), indicating that the program was feasible. Visual disturbances, communication/initiation deficits, and anxiety were more frequent in the group that did not adhere to the program. Emotional and social functioning, pain, appetite loss, constipation, and headache increased over time (clinically significant differences), whereas neuropsychological disturbances did not change. Half of the participants identified a family proxy and 8.6% wrote advance directives. One month before death, 28.6% of patients were receiving cancer treatment.
Integrating early palliative care in glioblastoma management is feasible. The potential benefits on QoL, mood, and survival must now be evaluated in a larger randomized controlled trial.
早期姑息治疗可改善癌症患者的生活质量（QoL）并延长生存期；然而，其对胶质母细胞瘤患者的影响仍不明确。GLIOSUPPORT研究评估了纳入胶质母细胞瘤标准治疗路径的早期姑息治疗方案的可行性（依从性；主要目标）。次要目标包括描述患者特征、QoL以及随时间变化的神经心理改变、临终决策、临终治疗和家庭照顾者的认知/经历。
这项干预性、前瞻性、纵向可行性研究在一家法国综合癌症中心进行。35例新诊断的胶质母细胞瘤患者需达到60%的依从率。依从性定义为参加每12周安排的3次姑息治疗门诊。比较了依从和未依从姑息治疗方案的患者的基线特征。采用最小临床重要差异和临界值来量化QoL变化。
依从率为60%（95%CI[42.1%-76.1%]），表明该方案可行。未依从该方案的组中视觉障碍、沟通/启动缺陷和焦虑更为常见。情绪和社会功能、疼痛、食欲减退、便秘和头痛随时间增加（具有临床显著差异），而神经心理障碍没有变化。一半的参与者指定了家庭代理人，8.6%的人撰写了预立医疗指示。死亡前一个月，28.6%的患者正在接受癌症治疗。
将早期姑息治疗纳入胶质母细胞瘤管理是可行的。现在必须在更大规模的随机对照试验中评估其对QoL、情绪和生存的潜在益处。
