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Health-related
quality of life in patients treated with temozolomide versus procarbazine for
recurrent glioblastoma multiforme
Osoba D, Brada M, Yung WK, Prados M
Quality of
Life Consulting, Vancouver, British Columbia, Canada. dosoba@bc.sympatico.ca
Purpose. To determine whether chemotherapy with temozolomide (TMZ) versus
procarbazine (PCB) for recurrent glioblastoma multiforme (GBM) was associated
with improvement in health-related quality of life (HRQOL).
Patients and Methods. HRQOL was assessed at baseline and during treatment using
the European Organization for Research and Treatment of Cancer Quality of Life
Questionnaire C30 and a Brain Cancer Module (BCM20) in two clinical trials that
enrolled a total of 366 patients.
Two hundred eighty-eight patients provided HRQOL data that could be used for
analysis; 109 patients received TMZ in a phase II study, whereas 89 patients
received TMZ and 90 received PCB in a randomized phase III study.
Changes from baseline in the scores of seven preselected HRQOL domains (role and
social functioning, global quality of life [QOL], visual disorders, motor
dysfunction, communication deficit, and drowsiness) were calculated for all
groups.
Statistical significance, effect sizes, and proportions of patients with
improved HRQOL scores (changes of > or = 10 points) were calculated.
Results. Before disease progression, patients treated with TMZ were found to
have an improvement in most of the preselected HRQOL domain scores compared with
their baseline (pretreatment) scores.
Those who were progression-free on TMZ at 6 months had improvement in all the
preselected HRQOL domains. Conversely, patients treated with PCB reported
deterioration in HRQOL that was independent of whether or not the disease had
progressed by 6 months.
Patients with disease progression, regardless of treatment, experienced a sharp
decline in all domains at the time of progression.
Conclusion. Treatment with TMZ was associated with improvement in HRQOL scores
compared with treatment with PCB.
The deterioration reported by PCB-treated patients was likely because of
toxicity.
Delaying disease progression by treatment with TMZ is beneficial to the HRQOL
status of patients with recurrent GBM.
PMID: 10735896 [PubMed - indexed for
MEDLINE]
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