TY - JOUR
T1 - The added value of health-related quality of life as a prognostic indicator of overall survival and progression-free survival in glioma patients
T2 - a meta-analysis based on individual patient data from randomised controlled trials
AU - Coomans, Marijke
AU - Dirven, Linda
AU - Aaronson, Neil K.
AU - Baumert, Brigitta G.
AU - van den Bent, Martin
AU - Bottomley, Andrew
AU - Brandes, Alba A.
AU - Chinot, Olivier
AU - Coens, Corneel
AU - Gorlia, Thierry
AU - Herrlinger, Ulrich
AU - Keime-Guibert, Florence
AU - Malmstrom, Annika
AU - Martinelli, Francesca
AU - Stupp, Roger
AU - Talacchi, Andrea
AU - Weller, Michael
AU - Wick, Wolfgang
AU - Reijneveld, Jaap C.
AU - Taphoorn, Martin J. B.
AU - EORTC Quality of Life Group
AU - EORTC Brain Tumor Group
N1 - Funding Information:
This study was funded with a grant from The European Organisation for Research and Treatment of Cancer ( EORTC ) Quality of Life Group.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/7
Y1 - 2019/7
N2 - Objective: Prognostic value of health-related quality of life (HRQoL) data may be important to inform patients in clinical practice and to guide clinical decision-making. Our study investigated the added prognostic value of HRQoL for overall survival (OS) and progression-free survival (PFS) in a large heterogeneous sample of glioma patients, besides known prognostic factors.Methods: We included individual baseline data from previously published randomised controlled trials (RCTs) in glioma patients in which HRQoL was assessed through the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BN20 questionnaires. Multivariable Cox regression models (stratified for newly diagnosed versus recurrent disease) were constructed, first with clinical variables (age, sex, tumour type, performance status, allocated treatment and extent of resection) only and subsequently with HRQoL variables added, separately for OS and PFS. The added prognostic value of HRQoL was calculated using C-indices.Results: Baseline HRQoL and clinical data from 15 RCTs were included, comprising 5217 patients. In the model including both clinical and HRQoL variables, better cognitive and role functioning and less motor dysfunction were independently associated with longer OS, whereas better role and cognitive functioning, less nausea and vomiting and more appetite loss were independently associated with prolonged PFS. However, C-indices indicated only a small prognostic improvement of the models for OS and PFS when adding HRQoL to the clinical prognostic variables (+1.1% for OS and +.7% for PFS).Conclusion: Our findings demonstrate that several baseline HRQoL variables are independently prognostic for OS and PFS, yet the added value of HRQoL to the known clinical prognostic variables was small. (C) 2019 Elsevier Ltd. All rights reserved.
AB - Objective: Prognostic value of health-related quality of life (HRQoL) data may be important to inform patients in clinical practice and to guide clinical decision-making. Our study investigated the added prognostic value of HRQoL for overall survival (OS) and progression-free survival (PFS) in a large heterogeneous sample of glioma patients, besides known prognostic factors.Methods: We included individual baseline data from previously published randomised controlled trials (RCTs) in glioma patients in which HRQoL was assessed through the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BN20 questionnaires. Multivariable Cox regression models (stratified for newly diagnosed versus recurrent disease) were constructed, first with clinical variables (age, sex, tumour type, performance status, allocated treatment and extent of resection) only and subsequently with HRQoL variables added, separately for OS and PFS. The added prognostic value of HRQoL was calculated using C-indices.Results: Baseline HRQoL and clinical data from 15 RCTs were included, comprising 5217 patients. In the model including both clinical and HRQoL variables, better cognitive and role functioning and less motor dysfunction were independently associated with longer OS, whereas better role and cognitive functioning, less nausea and vomiting and more appetite loss were independently associated with prolonged PFS. However, C-indices indicated only a small prognostic improvement of the models for OS and PFS when adding HRQoL to the clinical prognostic variables (+1.1% for OS and +.7% for PFS).Conclusion: Our findings demonstrate that several baseline HRQoL variables are independently prognostic for OS and PFS, yet the added value of HRQoL to the known clinical prognostic variables was small. (C) 2019 Elsevier Ltd. All rights reserved.
KW - Glioma
KW - Health-related quality of life (HRQoL)
KW - Prognostic factor
KW - Brain tumour
KW - Survival
KW - PHASE-III
KW - PREDICTING SURVIVAL
KW - CANCER-PATIENTS
KW - COGNITIVE FUNCTION
KW - CLINICAL-TRIALS
KW - BRAIN-TUMOR
KW - EORTC
KW - GLIOBLASTOMA
KW - VALIDATION
KW - SYMPTOMS
U2 - 10.1016/j.ejca.2019.05.012
DO - 10.1016/j.ejca.2019.05.012
M3 - Article
SN - 0959-8049
VL - 116
SP - 190
EP - 198
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -