P18.06 Quality of life and neurocognitive performance of patients with glioma surviving longer than five years after surgery and radiotherapy

摘要

Quality of life (QoL) and neurocognitive performance of patients with glioma surviving longer than five years after surgery and radiotherapy (RT) is not well established. Long term effects of radiotherapy (RT) and side effects of chemotherapy (CT), corticoids and anti-epileptic drugs might compromise patient’s outcomes. The aim of this study is to correlate the white matter lesion volume and the remaining volume of unchanged brain tissue with the cognitive status and QoL of long-term brain tumor survivors. PATIENTS AND METHODS: We tested patients surviving for at least five years for a histologically proven glioma, who have been treated with surgical resection, RT or RT and CT. Imaging data from the MRI at diagnosis and the actual MRI for this study were analyzed using the free neuroimaging software “MRIcron”. Furthermore, the patients were assessed with the EORTC QlQ30, the brain cancer module BN20, and neurocognitive testing using the Hopkin´s verbal learning test (HVLT), Trail making tests A and B (TMT A&B) and the controlled word association test (COWA). >Results: At this moment 31 patients are included in the study, 20 female and 11 male patients, aged from 20 to 85 years, in median 49 years. 6 patients were diagnosed with diffuse oligodendroglioma, 6 with oligoastrocytoma WHO grade II, 4 with diffuse astrocytoma, 4 with anaplastic oligodendroglioma, 2 with anaplastic oligoastrocytoma, 5 with anaplastic astrocytoma and 4 with glioblastoma. Despite having to deal with more negative symptoms patients report a better global health status than the healthy population. Professionally active patients reported a higher QoL than non-working patients. QoL results were not influenced by the volume of normal appearing brain tissue in MRI. The cognitive tests however showed that patients with a volume of normal appearing brain higher than average remember 1-2 words more in HVLT than patients with lower than average unchanged brain volume and are able to name 3 more words in the COWA. The TMT A (27 sec vs. 62 sec) and TMT B (66 sec vs 139 sec) were significantly different.The volume of gliosis visible in the MRI affected QoL as well as the cognitive status. Visible active tumor did not affect the cognitive status, but lowered the global health status. >Conclusions: QoL and neurocognitive outcomes show a high variety in long term surviving glioma patients. Testing patient´s reported outcomes and their cognitive performance adds valuable information allowing a more comprehensive view than imaging data only and should help to plan individually suitable support and rehabilitation measures.