P18.11 The effect of ketogenic diet on survival and quality of life in patients with malignant brain tumors in palliative care

Abstract Background The impact of primary malignant brain tumors on patient quality of life and psychological functioning is poorly understood, limiting the development of an evidence base for supportive interventions. We conducted a thorough systematic review and quality appraisal of the relevant literature to identify correlates of health-related quality of life (HRQoL) and psychological functioning (depression, anxiety and distress) in adults with primary malignant brain tumors. Method Twenty-three articles met predefined inclusion criteria from a pool of peer-reviewed literature published between January 1984 and July 2015 (N = 2407). Methodological quality of included studies was assessed using an adapted version of the Newcastle-Ottawa Scale. Results The overall methodological quality of the literature was moderate. Factors relating consistently with HRQoL and/or psychological functioning were cognitive impairment, corticosteroid use, current or previous mental health difficulties, fatigue, functional impairment, performance status and motor impairment. Conclusions Practitioners should remain alert to the presence of these factors as they may indicate patients at greater risk of poor HRQoL and psychological functioning. Attention should be directed towards improving patients' psychological functioning and maximizing functional independence to promote HRQoL. We outline several areas of future research with emphasis on improved methodological rigor.

Download Full-text

Suicidal ideation, depression, and health-related quality of life in patients with benign and malignant brain tumors: a prospective observational study in 83 patients

Acta Neurochirurgica ◽

10.1007/s00701-016-2844-y ◽

2016 ◽

Vol 158 (9) ◽

pp. 1669-1682 ◽

Cited By ~ 13

Author(s):

Anne-Katrin Hickmann ◽

Minou Nadji-Ohl ◽

Markus Haug ◽

Nikolai J. Hopf ◽

Oliver Ganslandt ◽

...

Keyword(s):

Quality Of Life ◽

Suicidal Ideation ◽

Brain Tumors ◽

Observational Study ◽

Prospective Observational Study ◽

Health Related Quality ◽

Malignant Brain Tumors ◽

Related Quality ◽

Health Related

Download Full-text

Quality of life in patients with malignant brain tumors.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.2058 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 2058-2058

Author(s):

Ali K. Choucair ◽

Lisa B.E. Shields

Keyword(s):

Quality Of Life ◽

Brain Tumors ◽

Group Differences ◽

Newly Diagnosed ◽

Significant Group ◽

Malignant Brain Tumors ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Prospective Longitudinal

2058 Background: A positive quality of life (QOL) serves as an important outcome priority in patients with malignant brain tumors whose survival is limited by tumor resistance to treatment. The FDA and ASCO have designated QOL as an outcome secondary in importance to survival. We conducted a prospective longitudinal collection of QOL measures (EORTC QLQ-C30, EORTC QLQ-BN20, and Hospital Anxiety and Depression Scale [HADS]) coupled with clinical standards of care (brain MRI and clinical history and physical examinations) in patients with newly diagnosed primary brain tumors (PBT). We also examined the QOL measures over time as related to tumor progression. Methods: Under an IRB-approved protocol, we reviewed the validated QOL measures and standard clinical measures from patients who were newly diagnosed with PBT. The patients were followed every 3 months over 2 years. No proxies were allowed. A total of 52 patients were enrolled in the study. Survey responses were compared between two tumor groups of patients: patients with tumor recurrence and/or died and patients without a recurrence (n=26 each group). A total of 17 patients succumbed to a tumor-related death. Statistical analysis utilizing non-parametric t-tests and Wilcoxon sign tests assessed QOL responses. Results: Significant group differences were noted in the questions of the QOL measures surveys with more negative responses in the recurrence group. The questions with significant group differences on the EORTC QLQ-C30 ranged from symptoms of dyspnea (p<.05) and difficulty sleeping (p<.05) as well as a poor QOL (p<.005) and pain interfering with daily activities (p<.05). Significant group differences of questions on the EORTC QLQ-BN20 included weakness of the legs (p<.05), coordination difficulties (p<.005), and unsteady gait (p<.05). Significant group differences of questions on the HADS reflected a patient who is "slowed down" (p<.01) and "frightened" (p<.05). Conclusions: Our analysis of questions answered by patients with newly diagnosed PBT may shed light on the impact of cancer and its treatment and potential recurrence on a patient's QOL. Further research is warranted to incorporate QOL measurements into improvement of patient care and their use in clinical trials and as a prognostic indicator.

Download Full-text