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Neurobehavioral Status and Health-Related Quality of Life in Newly Diagnosed High-Grade Glioma Patients

From the Departments of Medical Psychology, Neurology, Neurosurgery, and Pulmonology, Vrije Universiteit Medical Center; Department of Neurosurgery, Academic Medical Center, University of Amsterdam; Departments of Neurology and Radiation Oncology, Division of Psychosocial Research & Epidemiology, the Netherlands Cancer Institute, Amsterdam; Departments of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, the Netherlands.

Address reprint requests to M. Klein, PhD, Vrije Universiteit Medical Center, Department of Medical Psychology, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; email: m.klein.psychol{at}med.vu.nl

PURPOSE: To evaluate the health-related quality of life (HRQOL) and cognitive functioning of high-grade glioma patients in the postneurosurgical period.

PATIENTS AND METHODS: The HRQOL, as assessed by the Short-Form Health Survey-36, tumor-specific symptoms, and objective and subjective neuropsychologic functioning, of 68 newly diagnosed glioma patients were compared with that of 50 patients with non–small-cell lung cancer (NSCLC) and to age- and sex-matched healthy controls. The association between tumor lateralization, extent of resection, and use of medication, and the HRQOL outcomes was also investigated.

RESULTS: The HRQOL of the two patient groups was similar but significantly lower than that of the healthy controls. Glioma patients reported significantly more neurologic symptoms and poorer objective and subjective neuropsychologic functioning than the NSCLC patients. Using healthy controls as the reference group, cognitive impairment assessed at the individual patient level was observed in all glioma patients and 52% of the NSCLC patients. Poor performance on timed tasks in the glioma group could be attributed, in large part, to visual and motor deficits. Tumor lateralization was found to affect neuropsychologic functioning in a predictable manner. The extent of resection was not related significantly to neuropsychologic functioning. Corticosteroid use was associated with better recognition memory, whereas antiepileptic drug use was correlated negatively with working memory capacity.

CONCLUSION: The general HRQOL of glioma patients is similar to that of patients with NSCLC. However, they suffer from a number of condition-specific neurologic and neuropsychologic problems that have a significant impact on their daily lives in the postsurgical period, before treatment with radiotherapy.

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