Longitudinal assessment of quality of life, neurocognition, and psychopathology in patients with low-grade glioma on first-line temozolomide: A feasibility study

Amélie Darlix; Maëva Monnier; Florence Castan; Louise Coutant; Michel Fabbro; Ève Denis-Chammas; Mathilde Carrière; Nicolas Menjot-de-Champfleur; Valérie Rigau; Hugues Duffau; Estelle Guerdoux

doi:10.1093/noajnl/vdae084

Longitudinal assessment of quality of life, neurocognition, and psychopathology in patients with low-grade glioma on first-line temozolomide: A feasibility study

Neurooncol Adv. 2024 Jun 4;6(1):vdae084. doi: 10.1093/noajnl/vdae084. eCollection 2024 Jan-Dec.

Authors

Amélie Darlix^{1

2}, Maëva Monnier³, Florence Castan³, Louise Coutant⁴, Michel Fabbro², Ève Denis-Chammas⁵, Mathilde Carrière⁵, Nicolas Menjot-de-Champfleur⁵, Valérie Rigau^{1

6}, Hugues Duffau^{1

7}, Estelle Guerdoux^{4

8}

Affiliations

¹ Institut de Génomique Fonctionnelle, University of Montpellier, CNRS, INSERM, Montpellier, France.
² Department of Medical Oncology, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France.
³ Biometrics Unit, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France.
⁴ Department of Supportive Care, Psycho-Oncology Unit, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France.
⁵ Department of Neuroradiology, University of Montpellier, CHU Montpellier, Montpellier, France.
⁶ Department of Pathology, University of Montpellier, CHU Montpellier, Montpellier, France.
⁷ Department of Neurosurgery, University of Montpellier, CHU Montpellier, Montpellier, France.
⁸ Desbrest Institute of Epidemiology and Public Health (IDESP), INSERM, Montpellier Cancer Institute (ICM), University of Montpellier, France.

Abstract

Background: The treatment timing and choice after neurosurgical resection in patients with newly diagnosed diffuse low-grade glioma (DLGG) remain controversial. Indeed, the effect of such treatments must be balanced with the possible side effects. This study evaluated the feasibility of longitudinal exhaustive quality of life (QoL) and neuropsychological assessments in patients with DLGG receiving first-line temozolomide.

Methods: QoL, neurocognition, and psychological disorders were assessed prospectively until disease progression, using testing, clinician-reported, and self-reported questionnaires. The primary endpoint was the participation and adherence to this complete assessment at Baseline (before temozolomide initiation), months 6 and 12 of treatment, and month 6 post-treatment. The QoL and neuropsychological changes over time also were described.

Results: Twenty-six of the twenty-nine eligible patients were enrolled (participation rate: 89.7%, 95% CI: 72.6-97.8). The adherence rate was 95.7% (95% CI: 78.1-99.9; n = 23 because 3 patients progressed in the first 12 months of treatment). Up to month 6 post-treatment, QoL and fatigue remained stable (EORTC QLQC30 and BN20, MFI-20); some specific symptoms were transitory. Both subjective (FACT-Cog) and objective (Z-scores of neurocognitive tests) neurocognitive outcomes remained stable or tended to improve. The percentage of patients with severe depression (BDI-II), anxiety (STAI-Y), or anger (STAXI-II) was stable over time.

Conclusions: This prospective study demonstrated the feasibility of an exhaustive and longitudinal evaluation of QoL, neurocognition, and psychological disorders, with high acceptability by patients with DLGG undergoing chemotherapy. First-line temozolomide seems to have limited short-term effects on QoL and neurocognition. These findings must be confirmed in the long term and in a larger cohort.

Keywords: low-grade glioma; neurocognition; psychopathology; quality of life; temozolomide.