Follow up study on the quality of life and emotion in patients with low-grade gliomas through high or low dose radiotherapy after postoperative

doi:10.3877/cma.j.issn.2095-123X.2019.01.006

Abstract

Abstract:

Objective

To investigate the quality of life and psychological condition of patients with low-grade glioma undergoing surgery combined radiotherapy by the MOS item short from health survey (SF-36), anxiety scale (SAS) and self-rating depression scale (SDS) to assessment of patients with physical, psychological, mental, emotional state, etc. Investigate the effect of different doses of radiotherapy on the quality of life of patients with low-grade gliomas after operation, and to provide a favorable basis for the treatment of patients with low-grade glioma.

Methods

A total of 132 patients with low-grade glioma were recruited in the Department of Neurosurgery, Third Affiliated Hospital of Army Medical University from January 2012 to January 2016. All patients were randomized into three groups: 41 patients in the high dose radiotherapy group, 32 patients in the low dose radiotherapy group and 59 patients in the observation group (without radiotherapy, chemotherapy and other drugs after surgical resection of the tumor). Three groups of patients were followed up for 1 year, the quality of life and psychological assessed by SF-36, SAS and SDS were collected and statistical analyses.

Results

The results of SF-36 scale showed that the physiological function, physical pain, energy and social function of the high-dose radiation group were lower than those of the low-dose radiation group and the observation group (P<0.05). There was no significant difference among the three groups in physiological function, general health status, emotional function and mental health (P>0.05). The scores of SAS and SDS showed that the patients in the high dose radiation group and the low dose radiation group had more anxiety and depression tendency than those in the observation group, and the difference was statistically significant (P<0.05).

Conclusion

High-dose radiotherapy after low-grade glioma surgery has a certain impact on short-term quality of life of patients, and the recovery period is long. It is suggested that low-dose radiotherapy be given to patients with low-grade glioma after surgery. For younger patients with good prognosis, it is suggested that follow-up be observed after surgery to avoid the decline of life stock and the potential impact of radiation.

Key words: Low-grade glioma, Radiation therapy, Quality of life, Anxiety, Depression.

Hao Wang, Yihua Zhang, Xuhui Wang, Nan Zhang, Xuzhi He, Guangxin Chen, Donghong Yang, Liang Yi, Minhui Xu, Lunshan Xu. Follow up study on the quality of life and emotion in patients with low-grade gliomas through high or low dose radiotherapy after postoperative[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2019, 09(01): 25-29.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhnkjbykfzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-123X.2019.01.006

https://zhnkjbykfzz.cma-cmc.com.cn/EN/Y2019/V09/I01/25

Figures/Tables 3

References 19

[1]	Parisot S, Darlix A, Baumann C, et al. A probabilistic atlas of diffuse WHO grade II glioma locations in the brain[J]. PloS One, 2016, 11(1): e0144200.
[2]	De Witt Hamer PC, Hendriks EJ, Mandonnet E, et al. Resection probability maps for quality assessment of glioma surgery without brain location bias[J]. PloS One, 2013, 8(9): e73353.
[3]	Mangla R, Ginat DT, Kamalian S, et al. Correlation between progression free survival and dynamic susceptibility contrast MRI perfusion in WHO grade III glioma subtypes[J]. J Neurooncol, 2014, 116(2): 325-331.
[4]	Aghi MK, Nahed BV, Sloan AE, et al. The role of surgery in the management of patients with diffuse low grade glioma: A systematic review and evidence-based clinical practice guideline[J]. J Neurooncol, 2015, 125(3): 503-530.
[5]	Lips IM, van Gils CH, van der Heide UA, et al. Health-related quality of life 3 years after high-dose intensity-modulated radiotherapy with gold fiducial marker-based position verification[J]. BJU Int, 2009, 103(6): 762-767.
[6]	Windisch W, Freidel K, Schucher B, et al. Evaluation of health-related quality of life using the MOS 36-Item Short-Form Health Status Survey in patients receiving noninvasive positive pressure ventilation[J]. Intensive Care Med, 2003, 29(4): 615-621.
[7]	Samakouri M, Bouhos G, Kadoglou M, et al. Standardization of the Greek version of Zung’s Self-rating Anxiety Scale (SAS)[J].Psychiatriki, 2012, 23(3): 212-220.
[8]	Sakamoto S, Kijima N, Tomoda A, et al. Factor structures of the Zung Self-Rating Depression Scale (SDS) for undergraduates[J]. J Clin Psychol, 1998, 54(4): 477-487.
[9]	Karim AB, Afra D, Cornu P, et al. Randomized trial on the efficacy of radiotherapy for cerebral low-grade glioma in the adult: European Organization for Research and Treatment of Cancer Study 22845 with the Medical Research Council study BRO4: an interim analysis[J]. Int J Radiat Oncol Biol Phys, 2002, 52(2): 316-324.
[10]	van den Bent MJ, Afra D, de Witte O, et al. Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial[J]. Lancet, 2005, 366(9490): 985-990.
[11]	Vertosick FT Jr, Selker RG, Arena VC. Survival of patients with well-differentiated astrocytomas diagnosed in the era of computed tomography[J]. Neurosurgery, 1991, 28(4): 496-501.
[12]	Shaw EG, Scheithauer BW, Gilbertson DT, et al. Postoperative radiotherapy of supratentorial low-grade gliomas[J]. Int J Radiat Oncol Biol Phys, 1989, 16(3): 663-668.
[13]	Kiebert GM, Curran D, Aaronson NK, et al. Quality of life after radiation therapy of cerebral low-grade gliomas of the adult: results of a randomised phase III trial on dose response (EORTC trial 22844). EORTC Radiotherapy Co-operative Group[J]. Eur J Cancer, 1998, 34(12): 1902-1909.
[14]	Turel MK, Thakar S, Rajshekhar V. Quality of life following surgery for large and giant vestibular schwannomas: a prospective study[J]. J Neurosurg, 2015, 122(2): 303-311.
[15]	Asher R, Mason AE, Weiner J, et al. The relationship between preoperative general mental health and postoperative quality of life in minimally invasive lumbar spine surgery[J]. Neurosurgery, 2015, 76(6): 672-679.
[16]	van Gysen KL, Kneebone AB, Guo L, et al. Health-related quality of life using intensity-modulated radiation therapy for post-prostatectomy radiotherapy[J]. J Med Imaging Radiat Oncol, 2013, 57(1): 89-96.
[17]	Broniscer A, Chintagumpala M, Fouladi M, et al. Temozolomide after radiotherapy for newly diagnosed high-grade glioma and unfavorable low-grade glioma in children[J]. J Neurooncol, 2006, 76(3): 313-319.
[18]	Broniscer A, Baker SJ, Stewart CF, et al. Phase I and pharmacokinetic studies of erlotinib administered concurrently with radiotherapy for children, adolescents, and young adults with high-grade glioma[J]. Clin Cancer Res, 2009, 15(2): 701-707.
[19]	Kortmann RD. Radiotherapy in low-grade gliomas: pros[J]. Semin Oncol, 2003, 30(6 suppl 19): 29-33.

项目		观察组（n=59）	低剂量组（n=32）	高剂量组（n=41）	χ²/F值	P值
年龄（岁，Mean±SD）		43.28±5.5	42.31±7.8	39.75±6.2^a	3.823	0.024
女性		28（47.75）	14（43.75）	21（51.22）	0.405	0.817
肿瘤最大直径（mm，Mean±SD）		40±11	44±17	40±7^a	1.359	0.252
功能区受累		3（5.08）	9（28.13）^a	13（31.71）^a	13.489	0.001
病理结果		?	?	?	31.030	<0.001
?	星形细胞瘤	46	14^a	38^b	23.277	<0.001
?	少突胶质瘤	13	5	16	5.920	0.052
手术切除程度		?	?	?	?	?
?	全切	57（96.61）	12（37.50）^a	33（80.49）^ab	41.627	<0.001
?	非全切	2（3.39）	12（37.50）^a	16（39.02）^a	22.940	<0.001

项目		观察组（n=59）	低剂量组（n=32）	高剂量组（n=41）	χ²/F值	P值
年龄（岁，Mean±SD）		43.28±5.5	42.31±7.8	39.75±6.2^a	3.823	0.024
女性		28（47.75）	14（43.75）	21（51.22）	0.405	0.817
肿瘤最大直径（mm，Mean±SD）		40±11	44±17	40±7^a	1.359	0.252
功能区受累		3（5.08）	9（28.13）^a	13（31.71）^a	13.489	0.001
病理结果		?	?	?	31.030	<0.001
?	星形细胞瘤	46	14^a	38^b	23.277	<0.001
?	少突胶质瘤	13	5	16	5.920	0.052
手术切除程度		?	?	?	?	?
?	全切	57（96.61）	12（37.50）^a	33（80.49）^ab	41.627	<0.001
?	非全切	2（3.39）	12（37.50）^a	16（39.02）^a	22.940	<0.001

时间	组别	生理机能	生理职能	一般健康状况	情感职能	躯体疼痛	精力	精神健康	社会功能
?	观察组	59±5.61	58±6.25	46±3.34	45±4.04	54±6.17	52±4.19	50±3.62	48±3.22
?	低剂量组	64±10.21^a	62±6.61^a	42±5.56^a	31±6.23^a	54±7.36	56±5.75^a	52±3.50^a	45±1.98^a
术前	高剂量组	64±6.69^a	62±5.65^a	34±3.22^ab	32±4.33^a	55±3.65	56±4.52^a	54±3.78^ab	43±5.42^ab
?	F值	7.684	6.876	111.877	131.464	0.412	11.772	14.706	21.295
?	P值	0.001	0.001	<0.001	<0.001	0.663	<0.001	<0.001	<0.001
?	观察组	61±6.62	52±4.33	42±4.29	41±4.95	42±7.22	42±5.23	47±5.17	43±4.67
?	低剂量组	64±6.13^a	59±5.73^a	41±5.31	41±5.05	34±6.35^a	42±3.38	50±5.03^a	44±3.55^a
1个月	高剂量组	60±5.56^b	54±3.27^ab	41±3.18	39±3.52	32±4.33^a	34±3.61^ab	55±5.92^ab	34±4.12^a
?	F值	3.994	26.041	0.897	2.694	35.794	47.394	26.758	68.867
?	P值	0.021	<0.001	0.410	0.071	<0.001	<0.001	<0.001	<0.001
?	观察组	67±5.94	61±6.71	50±5.11	44±4.68	47±6.03	47±4.47	54±4.25	50±4.66
?	低剂量组	71±2.52^a	63±3.55	49±5.55	44±2.50	41±3.14^a	48±4.56	59±4.04^a	49±2.19
3个月	高剂量组	67±3.10^b	59±4.24^b	49±5.52	43±4.05	39±2.82^a	43±1.78^ab	59±2.22^a	41±1.09^ab
?	F值	9.521	5.019	0.571	0.860	40.775	18.579	30.053	94.59
?	P值	<0.001	0.008	0.566	0.426	<0.001	<0.001	<0.001	<0.001
?	观察组	73±4.66	72±6.70	56±4.65	53±3.77	49±5.55	52±4.77	67±4.54	64±3.59
?	低剂量组	73±3.16	72±2.87	55±6.01	52±4.11	49±3.19	52±5.33	67±4.17	48±4.75
6月	高剂量组	73±3.39	67±3.33^ab	52±2.36^ab	51±4.19^a	42±4.01^ab	49±3.92^ab	67±2.46	47±5.17^a
?	F值	<0.001	13.801	9.861	3.069	32.541	5.829	<0.001	229.885
?	P值	>0.999	<0.001	<0.001	0.049	<0.001	0.004	>0.999	<0.001
?	观察组	78±4.68	78±4.29	66±4.73	64±4.03	55±5.15	57±3.78	72±5.81	67±4.07
?	低剂量组	78±4.68	78±3.88	64±4.22	63±3.73	54±4.08	56±4.29	68±3.22	51±5.07
1年	高剂量组	76±3.07^ab	75±3.15^ab	61±3.11^ab	62±2.21^a	49±3.16^ab	50±5.28^ab	69±2.37^a	49±3.62^a
?	F值	3.135	8.497	17.442	4.011	24.249	32.581	10.400	272.465
?	P值	0.047	<0.001	<0.001	0.020	<0.001	<0.001	<0.001	<0.001

时间	组别	生理机能	生理职能	一般健康状况	情感职能	躯体疼痛	精力	精神健康	社会功能
?	观察组	59±5.61	58±6.25	46±3.34	45±4.04	54±6.17	52±4.19	50±3.62	48±3.22
?	低剂量组	64±10.21^a	62±6.61^a	42±5.56^a	31±6.23^a	54±7.36	56±5.75^a	52±3.50^a	45±1.98^a
术前	高剂量组	64±6.69^a	62±5.65^a	34±3.22^ab	32±4.33^a	55±3.65	56±4.52^a	54±3.78^ab	43±5.42^ab
?	F值	7.684	6.876	111.877	131.464	0.412	11.772	14.706	21.295
?	P值	0.001	0.001	<0.001	<0.001	0.663	<0.001	<0.001	<0.001
?	观察组	61±6.62	52±4.33	42±4.29	41±4.95	42±7.22	42±5.23	47±5.17	43±4.67
?	低剂量组	64±6.13^a	59±5.73^a	41±5.31	41±5.05	34±6.35^a	42±3.38	50±5.03^a	44±3.55^a
1个月	高剂量组	60±5.56^b	54±3.27^ab	41±3.18	39±3.52	32±4.33^a	34±3.61^ab	55±5.92^ab	34±4.12^a
?	F值	3.994	26.041	0.897	2.694	35.794	47.394	26.758	68.867
?	P值	0.021	<0.001	0.410	0.071	<0.001	<0.001	<0.001	<0.001
?	观察组	67±5.94	61±6.71	50±5.11	44±4.68	47±6.03	47±4.47	54±4.25	50±4.66
?	低剂量组	71±2.52^a	63±3.55	49±5.55	44±2.50	41±3.14^a	48±4.56	59±4.04^a	49±2.19
3个月	高剂量组	67±3.10^b	59±4.24^b	49±5.52	43±4.05	39±2.82^a	43±1.78^ab	59±2.22^a	41±1.09^ab
?	F值	9.521	5.019	0.571	0.860	40.775	18.579	30.053	94.59
?	P值	<0.001	0.008	0.566	0.426	<0.001	<0.001	<0.001	<0.001
?	观察组	73±4.66	72±6.70	56±4.65	53±3.77	49±5.55	52±4.77	67±4.54	64±3.59
?	低剂量组	73±3.16	72±2.87	55±6.01	52±4.11	49±3.19	52±5.33	67±4.17	48±4.75
6月	高剂量组	73±3.39	67±3.33^ab	52±2.36^ab	51±4.19^a	42±4.01^ab	49±3.92^ab	67±2.46	47±5.17^a
?	F值	<0.001	13.801	9.861	3.069	32.541	5.829	<0.001	229.885
?	P值	>0.999	<0.001	<0.001	0.049	<0.001	0.004	>0.999	<0.001
?	观察组	78±4.68	78±4.29	66±4.73	64±4.03	55±5.15	57±3.78	72±5.81	67±4.07
?	低剂量组	78±4.68	78±3.88	64±4.22	63±3.73	54±4.08	56±4.29	68±3.22	51±5.07
1年	高剂量组	76±3.07^ab	75±3.15^ab	61±3.11^ab	62±2.21^a	49±3.16^ab	50±5.28^ab	69±2.37^a	49±3.62^a
?	F值	3.135	8.497	17.442	4.011	24.249	32.581	10.400	272.465
?	P值	0.047	<0.001	<0.001	0.020	<0.001	<0.001	<0.001	<0.001

项目	组别	1个月	3个月	6个月	12个月
?	观察组	51.420±5.099	40.820±3.885	37.980±2.487	37.980±3.287
?	低剂量放射治疗组	52.043±4.708	41.903±3.219	38.642±3.236	37.612±1.676
SAS	高剂量放射治疗组	52.346±7.478	42.923±2.529^a	39.462±2.626^a	38.146±2.366
?	F值	0.323	4.803	3.577	0.363
?	P值	0.725	0.010	0.031	0.696
?	观察组	49.420±5.099	37.820±3.885	36.080±2.487	35.938±3.856
?	低剂量放射治疗组	50.342±5.418	38.223±3.229	36.672±3.606	35.436±2.686
SDS	高剂量放射治疗组	50.792±6.352	39.000±3.671	37.250±4.003	36.012±2.230
?	F值	0.779	1.256	1.537	0.351
?	P值	0.461	0.288	0.219	0.705

Please choose a citation manager

Content to export