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Health-Related Quality of Life in Patients Treated for Anaplastic Oligodendroglioma With Adjuvant Chemotherapy: Results of a European Organisation for Research and Treatment of Cancer Randomized Clinical Trial

Martin J.B. Taphoorn, Martin J. van den Bent, Murielle E.L. Mauer, Corneel Coens, Jean-Yves Delattre, Alba A. Brandes, Peter A.E. Sillevis Smitt, Hans J.J.A. Bernsen, Marc Frénay, Cees C. Tijssen, Denis Lacombe, Anouk Allgeier, Andrew Bottomley

From the Department of Neurology, Medical Center Haaglanden/Westeinde Ziekenhuis, the Hague; Department of Neurology, Daniel den Hoed Cancer Center/Erasmus University Hospital, Rotterdam; Department of Neurology, Canisius Wilhelmina Ziekenhuis, Nijmegen; Department of Neurology, Elisabeth Ziekenhuis, Tilburg, the Netherlands; Quality of Life Unit, and Data Center, European Organisation for Research and Treatment of Cancer, Brussels, Belgium; Department of Neurology, Centre Hospitalier Universitaire Pitié-Salpétrière, Paris; Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France; and Medical Oncology Department, Bellaria-Maggiore Ospedale, Bologna, Italy

Address reprint requests to Martin J.B. Taphoorn, MD, Medical Center Haaglanden/Westeinde Ziekenhuis, Department of Neurology, PO Box 432, the Hague, the Netherlands, 2501 CK; e-mail: m.taphoorn{at}mchaaglanden.nl

Purpose Little is known about the health-related quality of life (HRQOL) of patients treated for anaplastic oligodendrogliomas. The impact of combined procarbazine, CCNU (lomustine), and vincristine (PCV) chemotherapy after radiotherapy (RT) compared with RT alone on HRQOL in the randomized European Organisation for Research and Treatment of Cancer (EORTC) 26951 trial was studied.

Patients and Methods Adult patients with anaplastic oligodendrogliomas received RT alone or RT plus PCV chemotherapy. HRQOL was assessed with the EORTC Quality of Life Questionnaire C30 and Brain Cancer Module. Seven prespecified HRQOL end points were selected. We hypothesized that chemotherapy would impair HRQOL during treatment but that there would be a similar HRQOL between treatment arms once off treatment. Assessments were performed at randomization, at the end of RT, and then every 3 to 6 months until progression.

Results A total of 368 patients were randomly assigned to one of the two arms; overall, 58% were male, and the median age was 49 years. Compliance with HRQOL was 78% at baseline and dropped to 55% to 72% up to 2.5 years post-RT. Baseline scores demonstrated considerable impairments in HRQOL for both treatment groups. The longitudinal analysis showed a significant increase in nausea/vomiting in the RT plus PCV chemotherapy arm during and shortly after chemotherapy. Because of a difference in baseline scores for fatigue and physical functioning, the differences between treatment arms during PCV did not reach significance. The nonselected scales of appetite loss and drowsiness demonstrated significant differences between treatment arms during chemotherapy in favor of the RT arm. The long-term results showed no difference between arms.

Conclusion The major impact of PCV on HRQOL is on nausea/vomiting, loss of appetite, and drowsiness during and shortly after treatment. There are no long-term effects of PCV chemotherapy.

Supported by Grants No. 5U10CA11488-30 through 5U10CA11488-34 from the National Cancer Institute. Supported in part by the European Organisation for Research and Treatment of Cancer Charitable Trust.

Presented in part at the 13th Annual Conference of the International Society for Quality of Life Research, Lisbon, Portugal, October 10-14, 2006, and at the 11th Annual Meeting of the Society for Neurooncology, Orlando, FL, November 17-19, 2006.

The corresponding author (M.J.B.T.) had full access to all data in the study and had the final responsibility for the decision to submit for publication.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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