Abstract
The purpose of the study was to assesshealth-related quality of life (HQL) in patients withhigh-grade malignant glioma of the brain. The EORTCcore Quality of Life Questionaire (QLQ-C30) and aBrain Cancer Module (BCM20) were administered at baselineand several weeks later (follow-up) to 105 patientswith either recently-diagnosed (n=41) or recurrent(n=64) malignant glioma. In addition, theattending neurologists completed a standard neurological examination, amodified Barthel Activities of Daily Living Index (BADLI)and the Karnofsky Performance Scale (KPS). In apreliminary step, the QLQ-C30 was found to haveacceptable reliability (internal consistency and test-retest reliability). Newly-diagnosedpatients and those with a KPS of 80–100had significantly better physical, role and cognitive functioningand global quality of life with less fatigue,visual disorder, motor dysfunction, communication deficit, weakness ofboth legs and trouble controlling the bladder thandid those with recurrent disease and those witha KPS of 50–70. Similarly, those capable ofindependent activities of daily living, as reported onthe BADLI, had higher functioning scores and lessfatigue than did those who were not independent.Patients with dysphasia, mental confusion or motor deficiton neurological examination reported significantly lower levels ofphysical, role, cognitive, emotional and social functioning andglobal quality of life than did patients nothaving these difficulties. They also had significantly moresymptoms. In patients with deteriorating neurological status betweenbaseline and follow-up, there was a marked declinein cognitive, physical, role, emotional and social functioningand global quality of life and an increasein fatigue. Thus, there are significant differences inHQL between patients with newly-diagnosed and recurrent braincancer and between patients with differing KPS andBADLI scores. In addition, the HQL scores providedetails not provided by the KPS and theBADLI. Deterioration in neurological function is accompanied bysignificant deterioration in a range of HQL domainsand in global quality of life.
Similar content being viewed by others
References
McKeran RO, Thomas DGT: The clinical study of gliomas. In: Thomas DGT, Graham DI (eds) Brain Tumours: Scientific Basis, Clinical Investigation and Current Therapy. 194–230, 1980
Archibald YM, Lunn D, Ruttan LA, Macdonald DR, Del Maestro RF, Barr HW, Pexman JH, Fisher BJ, Gasper LE, Cairncross JG: Cognitive functioning in long-term survivors of high-grade glioma. J Neurosurg 80: 247–253, 1994
Taphoorn MJB, Heinmans JJ, Snoek FJ, Lindeboom J, Oosterink B, Wolbers JG, Karim ABMF: Assessment of quality of life in patients treated for low-grade glioma: a preliminary report. J Neurol Neurosurg Psychiat 55: 372–376, 1992
Grant R, Slattery J, Gregor A, Whittle IR: Recording neurological impairment in clinical trials of glioma. J Neuro-Oncol 19: 37–39, 1994
Mackworth N, Fobair P, Prados MD: Quality of life self-reports from 100 brain tumor patients: comparisons with Karnofsky performance scores. J Neuro-Oncol 14: 243–253, 1992
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, Kaasa S, Klee M, Osoba D, Razavri D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F: The European Organization for Research and Treatment of Cancer QLQC30: a quality-of-life instrument for use in international trials in oncology. J Natl Cancer Inst 85: 365–376, 1993
Karnofsky DA, Abelmann WH, Craver LF, Burchenal JH: The use of nitrogen mustards in palliative treatment of carcinoma. Cancer 1: 634–656, 1948
McDowell I, Newell C: Measuring Health: A Guide to Rating Scales and Questionnaires. The Barthel Index. Oxford, Oxford University Press 49–54, 1987
Osoba D, Aaronson NK, Muller M, Sneeuw K, Hsu M-A, Yung WKA, Brada M, Newlands E: The development and psychometric validation of a brain cancer quality-of-life questionnaire for use in combination with general cancer-specific questionnaires. Qual Life Res 5: 139–150, 1996
Osoba D: The Quality of Life Committee of the Clinical Trials Group of the National Institute of Canada: organization and functions. Qual Life Res 1: 211–218, 1992
Bergman B, Sullivan M, Sörenson S: Quality of life during chemotherapy for small cell lung cancer. II. A longitudinal study of the EORTC Core Quality of Life Questionnaire and comparison with the Sickness Impact Profile. Acta Oncol 3119–3128, 1992
Bjordal K, Kaasa S: Psychometric validation of the EORTC Core Quality of Life Questionnaire, a 30-item version and a diagnosis-specific module for head and neck cancer patients. Acta Oncol 31: 311–321, 1992
Osoba D, Zee B, Pater J, Warr D, Kaizer L, Latreille J: Psychometric properties and responsiveness of EORTC Quality of Life Questionnaire (QLQ-C30) in patients with breast, ovarian and lung cancer. Qual Life Res 3: 353–364, 1994
Niezgoda HE, Pater JL: A validation study of the domains of the core EORTC Quality of Life Questionnaire. Qual Life Res 2: 215–319, 1993
Ringdal GI, Ringdal K: Testing the EORTC Quality of Life Questionnaire on cancer patients with heterogeneous diagnoses. Qual Life Res 2: 129–140, 1993
Sigurdardottir V, Bolund C, Brandberg Y, Sullivan M: The impact of generalized malignant melanoma on quality of life evaluated by the EORTC questionnaire technique. Qual Life Res 2: 193–203, 1993
Hjermstad MJ, Fossa SD, Bjordal K, Kaasa S: Test-retest study of the European Organization for Research Treatment Core Quality-of-Life Questionnaire. J Clin Oncol 13: 1249–1254, 1995
Wisloff F, Ecka S, Hippe E, Hjorth M, Holmberg E, Kaasa S, Palva I, Westin J: Measurement of health-related quality of life in multiple myeloma. Nordic Myeloma Study Group. Br J Haematol 92: 604–613, 1996
Kaasa S, Bjordal K, Aaronson N, Moum T, West E, Hagen S, Kvitstad A: The EORTC Core Quality of Life Questionnaire (QLQ-C30): validity and reliability when analysed with patients treated with palliative radiotherapy. Eur J Cancer 31A: 2260–2263, 1995
Groenvold M, Bjorner JB, Klee M, Kreiner S: Test for item bias in a quality of life questionnaire. J Clin Epidemiol 48: 805–816, 1995
Schaafsma J, Osoba D: The Karnofsky performance status scale re-examined: a cross-validation with the EORTC-C30. Qual Life Res 3: 413–424, 1994
Sadura A, Pater J, Osoba D, Levine M, Palmer M, Bennet K: Quality-of-life assessment: patient compliance with questionnaire completion. J Natl Cancer Inst 84: 1023–1026, 1992
Osoba D, Dancey J, Zee BC, Myles J, Pater J: Health-related quality-of-life studies of the National Cancer Institute of Canada Clinical Trials Group. Monogr Natl Cancer Inst 20: 107–111, 1996
Cronbach LJ: Coefficient alpha and the internal structure of tests. Psychometrika 16: 297–334, 1951
Steel RGD, Torrie JH: Principles and Procedures of Statistics. 2nd ed. McGraw-Hill, New York, 1960
Weitzner MA, Meyers CA, Gelke CK, Byrne KS, Cella DF, Levin VA: The Functional Assessment of Cancer Therapy (FACT) Scale. Development of a brain subscale and revalidation of the general version (FACT-G) in patients with primary brain tumours. Cancer 75: 1151–1161, 1995
Osoba D, Aaronson N, Zee B, te Velde A, Sprangers M: Modification of the EORTC QLQ-C30 based on reliability testing in large samples of patients with cancer. Qual Life Res 4: 468, 1995 (abstract)
Schipper H, Clinch J, McMurray A, Levitt M: Measuring the quality of life of cancer patients: the Functional Living Index–Cancer: development and validation. J Clin Oncol 2: 472–483, 1984
Coscarelli Schag CA, Ganz PA, Heinrich RL: Cancer Rehabilitation Evaluation system–Short Form (CARES-SF). A cancer specific rehabilitation and quality of life instrument. Cancer 68: 1406–1413, 1991
Selby PJ, Chapman J-AW, Etazadi-Amoli J: The development of a method for assessing quality of life in cancer patients. Br J Cancer 50: 13–22, 1984
Morrow GR, Lindke J, Black P: Measurement of quality of life in patients: psychometric analyses of the Functional Living Index-Cancer (FLIC). Qual Life Res 1: 287–296, 1992
Bliss JM, Selby PJ, Robertson B, Powles TJ: A method for assessing the quality of life of cancer patients: replication of the factor structure. Br J Cancer 65: 961–966, 1992
Sneeuw KCA, Aaronson NK, Osoba D, Muller MJ, Hsu M-A, Yung WKA, Brada M, Newlands ES: The use of significant others as proxy raters of the quality of life of patients with brain cancer. Qual Life Res 4: 486, 1995 (abstract)
Sneeuw KCA, Aaronson NK, Osoba D, Muller MJ, Hsu M-A, Yung WKA, Brada M, Newlands ES: The use of significant others as proxy raters of the quality of life of patients with brain cancer. Med Care 1996, in press
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Osoba, D., Aaronson, N., Muller, M. et al. Effect of neurological dysfunction on health-related quality of life in patients with high-grade glioma. J Neurooncol 34, 263–278 (1997). https://doi.org/10.1023/A:1005790632126
Issue Date:
DOI: https://doi.org/10.1023/A:1005790632126