Much attention is given to high-grade gliomas and the intense symptom burden on quality-of-life (QoL) but less is known about the adaptability to symptoms/challenges for patients with LGGs. Adaptive Leadership provides a novel conceptualization of symptom self-management for LGG patients as it promotes patient-centered, adaptive techniques/strategies for management of symptoms and resulting challenges to improve QoL.
During the first 6 months post LGG diagnosis: Identify/describe patterns in symptoms/QoL measured by valid/reliable tools; Identify/describe through qualitative interviews patient/provider adaptive techniques/strategies; Describe relationships among patient characteristics (including biomarkers), symptoms/QoL, and adaptive techniques/strategies.
Fifteen patients >18yrs, KPS≥70%, and ≤2-months post Grade II-LGG diagnosis were enrolled. FACT-G/Br/Cog, Beck-Depression-Inventory (BDI)-II, FACIT-fatigue, distress-scale were completed at 2, 4, and 6-months post-diagnosis. Qualitative interviews identifying symptoms/challenges and adaptive techniques/strategies were conducted to code themes at 4 and 6 months. Trajectory of change in symptoms/QOL was described using means and 95% confidence intervals.
Mean age=40, 27% male, 93% white, 40% KPS≥90%, 67% gross total resection; majority (67%) with frontal tumors. Pathology included diffuse astrocytoma/infiltrating glioma (60%) and oligodendroglioma (40%), 1p19q-codeletions (40%), IDH1mut (60%), and TERTmut (53%). Mean QoL scores at 2,4,6 months, respectively were FACT-Brain-Subscale (0-76):50,50,54; FACT-BR (0-184):126,126,130; FACT-Cog-impairment-subscale (0-72):50,49,46; BDI-II (0-63): 15.2,16.5,13.9; Distress (1-4):2.2,1.5,1.8. FACIT-Fatigue scores (0-52):31,32,35 suggest a clinically important decrease in fatigue (+/-3). Initial analyses suggest that patients with either IDH1mut, TERTmut consistently reported lower QoL and higher distress, depression, fatigue scores. Seizures were reported with IDH1mut (11%) but not IDH1wildtype. Lower QoL, depression, fatigue were seen with 1p19q-codeletions. Males reported higher QoL and lower depression/fatigue. Qualitative interview data will be presented identifying sustainable adaptive strategies in association with characteristics, symptoms and challenges.
1p19q-codeletions and IDH1/TERTmut may be related to lower QoL (from IDH1mut-related seizures). Future studies to explore 1p19q-codeletions/IDH1/TERTmut subtypes as predictors for QoL/adaptability to symptoms/challenges should be conducted.
Journal Article. 0 words.
Subjects: Medical Oncology ; Neurology
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