Publication Date:
2016-12-02
Description:
Background Primary CNS lymphoma (PCNSL) is a rare extra nodal non-Hodgkin lymphoma. High-dose methotrexate (HD-MTX) based treatment has improved prognosis, but little is known about the development of quality of life (QoL) during treatment and follow-up from prospective trials. Methods We pooled data from three prospective trials including 225 immunocompetent patients with PCNSL (186 [83%] with newly diagnosed and 39 [17%] with relapsed disease) - all received HD-MTX based polychemotherapy with rituximab. QoL was a pre-specified secondary endpoint in all trials and evaluated using the EORTC QLQ-C30 and EORTC QLQ-BN20 questionnaire at start of treatment, after completion of treatment and during follow-up. We used descriptive statistics to summarize QoL over time. To investigate the development of QoL over time adjusted for age and Karnofsky performance status (KPS), we used multivariable linear regression models with a random effect to account for repeat measurements. We also did two separate analyses for patients with newly diagnosed PCNSL and relapsed disease. Multiple imputations were applied for missing values within a questionnaire, but we did not impute values of questionnaires that were missing completely. We herein report results on the global health status (GHS, item 30 of EORTC QLQ-C30, higher values represent better QoL) and the predominant item of the EORTC QLQ-BN20 (future uncertainty, higher values represent worse QoL). A change of 10% on the respective scale was considered as a clinically meaningful difference (Osoba et al, Eur J Cancer. 2005 Jan;41(2):280-7 and Maringwa et al, Ann Oncol. 2011 Sep;22(9):2107-12). Results The median age and KPS was 62 years (range 20 to 85) and 80% (30% to 100%), respectively, 119 (52%) were female. Before treatment, the median GHS of the EORTC QLQ-C30 was 50 (interquartile range [IQR] 33 to 67) reflecting substantial impaired QoL. After completion of treatment, the median GHS significantly increased by 17 points to a median of 67 (IQR 50 to 71) (P
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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