Skip to main content
Log in

Effect of neurological dysfunction on health-related quality of life in patients with high-grade glioma

  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. 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

  2. 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

    Google Scholar 

  3. 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

    Google Scholar 

  4. Grant R, Slattery J, Gregor A, Whittle IR: Recording neurological impairment in clinical trials of glioma. J Neuro-Oncol 19: 37–39, 1994

    Google Scholar 

  5. 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

    Google Scholar 

  6. 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

    Google Scholar 

  7. Karnofsky DA, Abelmann WH, Craver LF, Burchenal JH: The use of nitrogen mustards in palliative treatment of carcinoma. Cancer 1: 634–656, 1948

    Google Scholar 

  8. McDowell I, Newell C: Measuring Health: A Guide to Rating Scales and Questionnaires. The Barthel Index. Oxford, Oxford University Press 49–54, 1987

    Google Scholar 

  9. 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

    Google Scholar 

  10. 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

    Google Scholar 

  11. 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

  12. 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

    Google Scholar 

  13. 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

    Google Scholar 

  14. 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

    Google Scholar 

  15. Ringdal GI, Ringdal K: Testing the EORTC Quality of Life Questionnaire on cancer patients with heterogeneous diagnoses. Qual Life Res 2: 129–140, 1993

    Google Scholar 

  16. 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

    Google Scholar 

  17. 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

    Google Scholar 

  18. 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

    Google Scholar 

  19. 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

    Google Scholar 

  20. 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

    Google Scholar 

  21. 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

    Google Scholar 

  22. 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

    Google Scholar 

  23. 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

    Google Scholar 

  24. Cronbach LJ: Coefficient alpha and the internal structure of tests. Psychometrika 16: 297–334, 1951

    Google Scholar 

  25. Steel RGD, Torrie JH: Principles and Procedures of Statistics. 2nd ed. McGraw-Hill, New York, 1960

    Google Scholar 

  26. 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

    Google Scholar 

  27. 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)

    Google Scholar 

  28. 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

    Google Scholar 

  29. 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

    Google Scholar 

  30. 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

    Google Scholar 

  31. 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

    Google Scholar 

  32. 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

    Google Scholar 

  33. 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)

    Google Scholar 

  34. 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

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints 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

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1005790632126

Navigation