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Palliative Radiation Therapy Improves QoL in HG Glioma

TOPLINE:

Short-course hypofractionated palliative radiation therapy improves quality of life in patients with poor-prognosis, high-grade gliomas.

METHODOLOGY:

  • Uncertainty persists about the value of palliative radiation, particularly longer regimens, among patients with high-grade gliomas. 

  • To address the uncertainty, investigators administered quality of life (QoL) questionnaires to patients before receiving 35 Gy of palliative radiation in 10 fractions over 2 weeks, then again 1 month after treatment, followed by every 3 months until disease progression or death.

  • Overall, 49 of 55 patients (89%) completed radiation treatment, and 42 completed the surveys. 

  • QoL was assessed using the 100-point European Organization for Research and Treatment of Cancer QoL core questionnaire (QLQ-C30) and its brain cancer module (BN20).

  • Two thirds of patients were treated with temozolomide chemotherapy following radiation.

TAKEAWAYS:

  • There was clinically and statistically significant improvement 1 month after radiation therapy in patient-reported fatigue and dyspnea on the QLQ-C30.

  • A clinically meaningful improvement — meaning a 10-point or greater improvement — was also seen for insomnia. Other symptoms, such as nausea/vomiting, loss of appetite, constipation, diarrhea, and financial difficulty, remained stable over time.

  • On the BN20, investigators reported clinically and statistically significant improvement in motor function; other symptoms remained stable. 

  • Median progression-free survival was 8.4 months; median overall survival was 10.5 months.

IN PRACTICE:

“Short-course palliative hypofractionated radiotherapy in patients with poor-prognosis [high-grade glioma] does not impair QoL in the short term; but is rather associated with stable and/or improved QoL scores in several domains/symptom scales” at 1-3 months after treatment, “making it a viable resource-sparing alternative regimen,” the authors concluded.

SOURCE:

The work, led by Y. Baviskar of the Tata Memorial Hospital Department of Radiation Oncology in Mumbai, India, was published July 11 in  Clinical Oncology.

LIMITATIONS:

  • It was a single-center study with no control arm.

  • Fewer patients completed QoL forms over time, limiting longitudinal assessment to 3 months.

  • Forms might have been completed by caregivers at times, raising questions about the veracity of responses.

DISCLOSURES:

  • There was no external funding for the work.  

  • The investigators report no relevant financial relationships.

M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who worked for several major news outlets before joining Medscape. Alex is also an MIT Knight Science Journalism fellow. Email:  [email protected].

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  • Posted on July 24, 2023