Patients with glioblastoma have a poor outlook, with median survivals of 9-12 months. Those given the drug temozolomide in combination with radiotherapy have improved survival when compared with those given radiotherapy alone. However, it has been thought that any increased survival benefit from temozolomide might be at the cost of additional toxicity to patients.
Taphoorn and colleagues investigated this possibility using data from a randomised phase III trial involving 573 patients to measure health-related quality of life (HRQOL). They used specialised questionnaires to assess HRQOL at baseline and every 3 months during treatment with either radiotherapy alone or Temozolomide and radiotherapy until the disease progressed.
Baseline questionnaires were available for 86% (490/573) of patients and HRQOL did not differ between groups at baseline. Overall, there were no significant differences in 6 of 7 HRQOL measures; fatigue, global health, emotional functioning, future uncertainty, insomnia, and communication deficit. At 3 months, patients in the radiotherapy-alone group had better social functioning than those given the combination treatment. However, after 3 months, HRQOL was much the same between the two groups. The study therefore shows that this drug has great promise in improving survival but not at the expense of patients' quality of life.
Dr Taphoorn states "Health-related quality of life has become an increasingly important endpoint in cancer studies... and is most relevant in patients who cannot be cured of disease". He continues, "This new treatment might be not only an effective approach for these patients, but also treatment without a detrimental effect on HRQOL during the first year of follow-up".
Contact: Dr Martin J B Taphoorn, Medical Centre Haaglanden, Department of Neurology/Neuro-Oncology, PO Box 432, 2501 CK The Hague, The Netherlands. T: 00 31 70 3302000. Email: m.taphoorn@mchaaglanden.