KS04.7.A HEALTH-RELATED QUALITY OF LIFE AND COGNITIVE FUNCTIONING IN SURVIVORS OF OLIGODENDROGLIOMA: AN INTERNATIONAL CROSS-SECTIONAL INVESTIGATION
Authors: Boele F W , Frances S M , Darlix A , Ducray F , Tabouret E , Burger M C , Ryden I , Malmstrom A , Vauleon E , Kazda T , Renovanz M , Werner J , Welsh L , Sanghera P , Dehais C , Desideri I , McBain C , Mehta S , Lord H , Jena R , Foweraker K , Ashkan K , Engelhardt J , Bourg V , Herrlinger U , Lawson McLean A , Hertler C , Haldbo-Classen L , Dahlrot R H , Noel G , Durando X , Hrab I , Razis E , Muhic A , Klein M 
Published: October 2024

Abstract

BACKGROUND
Patients with IDH-mutant, 1p/19-codeleted oligodendroglioma have a relatively favourable prognosis and can experience long periods of stable disease. Treatment modalities used vary, and the long-term impacts of both the tumour itself and its treatment on patient health-related quality of life (HRQOL) and cognition remain largely unclear. We aimed to investigate associations between treatment and functioning of oligodendroglioma patients ≥5 years after diagnosis.

MATERIAL AND METHODS
In this international cross-sectional observational study, patients with histologically and molecularly confirmed oligodendroglioma (IDH mutant, 1p/19q codeleted) diagnosed ≥5 years ago, were recruited through the European Organisation for Research and Treatment of Cancer (EORTC) networks. Diagnosis and treatment data were collected from medical records; patients completed outcomes for HRQOL (EORTC QLQ-C30; BN20), self-reported cognitive functioning (MOS Cognitive Functioning Scale) and cognitive tests (HVLT-R, TMT, COWAT) once. Associations between HRQOL and cognition outcomes, and clinical variables (time since diagnosis; progression; tumour location; treatments delivered; current medication; Karnofsky Performance Status (KPS)) were explored with regression analyses.

RESULTS
242 oligodendroglioma patients on average 9.9 years post-diagnosis (sd=4.3, range=5.0-26.3) took part from 33 sites across 9 countries. Patients were M=52 years old (sd=12, range=23-78), the majority were men (N=145; 60%). Higher KPS, no radiotherapy (ever), no current medication (anxiolytics/sedatives, antidepressants, dexamethasone) were associated with better generic HRQOL outcomes (QLQ-C30 functioning scale models; R2 range 0.068-0.371, all p&lt;.001). Higher KPS, fewer recurrences, no radiotherapy treatment (ever), and no current antidepressant use were of predictive value for better disease-specific HRQOL (BN20 multi-item scale models; R2 range 0.067-0.246, p&lt;0.001). Fewer subjective cognitive complaints were associated with higher KPS and no current antipsychotic medication use (R2=0.153, p&lt;0.001). Better KPS, right hemispheric tumours, longer time since diagnosis, no chemotherapy (ever), no radiotherapy (ever), and no current medication use (dexamethasone, antipsychotics) were predictive of better cognitive functioning (multivariable models R2 range 0.056-0.248, p&lt;0.001).

CONCLUSION
In oligodendroglioma survivors ≥5 years after diagnosis, better HRQOL and cognitive outcomes appear consistently linked with higher KPS, no current medication use and no radiotherapy (ever); with cognitive outcomes additionally associated with chemotherapy treatment. This information can support treatment decision-making. Targeted evaluation and support for patients should be implemented to optimise clinical outcomes.