Glioblastoma: quality of life as a key element in evaluation of radiation treatment effectiveness
Authors: Glavatskyi O.Ya. , Gryazov A.B. , Chuvashova O.Yu. , Kruchok I.V. , Starenkyi V.P. , Ivankova V.S. , Talko V.V. , Nasonova A.M. 
Published: April 2024

Background. Along with the traditional assessment of oncological outcomes with a focus on survival, information about the patient’s quality of life (QOL) plays a key role in evaluating the effectiveness of treatment. The QOL assessment reflecting a person’s subjective perception of their situation in the disease context is now considered a tool for changing the current paradigm of therapeutic effectiveness, including that in neuro-oncology. Modern high-tech radiation therapy offers wide possibilities for modifying radiation regimens, in particularly, by means of hypofractionation. Given the considerable clinical benefits of the latter, there is a growing interest in studies that include QOL assessment along with conventional biomedical outcomes, particularly in patients with glioblastoma. Purpose. This analytical review focuses on the clinical aspects of QOL assessment in the context of radiation treatment of glioblastoma patients, beyond the discussion of oncological outcomes. Materials and methods. References were analyzed using English-language biomedical databases (MEDLINE (Pubmed), EMBASE (Ovid), Web of Science (Web of Knowledge) using the following Keywords: «Quality of life», «Health-related quality of life», «Radiation Therapy», «Hypofractionated radiotherapy», «Hypofractionated irradiation», «CNS tumors», «Brain tumors», «Glioblastoma». When analyzing all sources, backlinks were made to the original sources to identify the additional relevant studies. The last date of the search was February 01, 2024. Results. Nowadays, QOL assessment is broadly integrated into the neuro-oncology practice. This analysis is used for the comprehensive treatment outcome assessment in various clinical scenarios, including modification of radiation therapy regimens. The results of cancer treatment are not considered satisfactory if the survival is not associated with the maintenance of QOL. The main tool for QOL assessment is the EORTC QLQ-C30 questionnaire; for patients with brain tumors, there is an additional specific module BN-20. QOL analysis demonstrates the benefits of hypofractionated radiation therapy for glioblastoma patients, as a reduced radiation course has a favorable impact on QOL, without significant difference in toxicity and expected survival compared to standard regimens. The QOL study proves the positive effect of combining adjuvant radiation therapy and neurorehabilitation for glioblastoma patients using virtual reality technology. It has been established that QOL remains stable following re-irradiation of patients with recurrent gliomas. QOL analysis provides the opportunities to reveal the medical and social aspects of neuro-oncological diseases and demonstrates the burden of the disease not only for the person directly affected by glioblastoma, but also for those who care for the patient. The number of publications dedicated to the QOL assessment in proton radiation therapy is growing. Conclusion. If there is no significant difference between the toxicity of treatments (including radiation) and expected survival, QOL can serve as a criterion for an optimal therapy selection. QOL analysis is used for the comprehensive treatment outcome assessment in various clinical scenarios, including modification of radiation therapy regimens (e.g., hypofractionation). QOL analysis is complex and requires unification. Acquiring the methodology of QOL assessment is a necessary requirement for researchers involved in modern neuro-oncology studies.