Quality of life in adults with low grade gliomas: a systematic review


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Ben Rimmer1, Iakov Bolnykh1, Lizzie Dutton1, Fiona Menger1, Linda Sharp1
1Newcastle University

Abstract

Background

Adults diagnosed with low-grade gliomas (LGG) have an average survival of 5-15 years. The tumour, future chance of progression, treatment and associated side-effects mean they can face prolonged quality of life (QoL) impairments. We systematically identified quantitative studies assessing QoL in adult LGGs, for: areas impacted, associated factors, temporal trends, and difference to comparators.

Method

MEDLINE, CINAHL, Embase, PubMed, and PsycINFO were systematically searched for studies published in English from inception to 10th December 2020. Two reviewers independently screened for eligibility. Data was abstracted on study and population characteristics, and QoL findings. Study quality was appraised.

Results

Twenty-seven papers reporting 19 studies across 11 countries, were identified, with largely good quality. There was substantial heterogeneity in time since diagnosis and QoL instrument used. Twelve studies examined several predictors (e.g. age) of QoL. Studies were cross-sectional (n=12) or longitudinal (n=7). Ten studies included comparators, mainly high-grade glioma (HGG) patients (n=6) or non-cancer controls (n=4).
Global QoL in LGGs is poor, with considerable functioning impairments and symptom burden, most notably cognitive functioning and cancer-related fatigue. Twenty-two factors positively (n=14; e.g. post-traumatic growth and higher education) or negatively (n=13; e.g. post-traumatic stress disorder and epilepsy burden) influenced QoL. Over time, QoL typically remained low, but stable, and though better than in HGG, was substantially worse than in non-cancer controls.

Conclusion

LGGs experience a wide range of QoL impairments. Research may have captured the ‘well’ population, by excluding LGGs with cognitive and communication impairments.

Impact statement

These findings may help clinicians recognise what, and when, support is necessary and inform future intervention development.