Longitudinal Assessment of Quality of Life, Neurocognition, and Psychopathology in Patients with Low-Grade Glioma on First-Line Temozolomide: A Feasibility Study.

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. Diffuse low-grade glioma (DLGG) is a common brain tumor. Some patients, but not all, receive a chemotherapy called temozolomide (TMZ) after surgery, but the effect of this treatment on quality of life is not clear. The authors of this study wanted to find out if a complete, longitudinal assessment of quality of life and neurocognition was feasible, and to explore how TMZ impacts these aspects in patients with DLGG. To do this, they assessed a group of 26 patients with LGG receiving TMZ using testing, clinician-reported and self-reported questionnaires before treatment and then again 6 and 12 months after starting treatment. Their results show these evaluation are feasible and TMZ seems to have limited short-term impact on quality of life and neurocognition, but larger studies and long-term evaluations are needed to confirm this finding.