Patient Reported Outcomes/Quality of Life

PV QA 4 - Poster Viewing Q&A 4

TU_40_3709 - Gender Differences in Health-Related Quality of Life (hrQOL) in Patients Undergoing Intracranial RT

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Gender Differences in Health-Related Quality of Life (hrQOL) in Patients Undergoing Intracranial RT
J. Burkeen1, T. Pan1, Y. Dalia2, Y. Sharifzadeh3, D. C. Marshall4, C. McDonald4, and J. A. Hattangadi-Gluth4; 1University of California San Diego, La Jolla, CA, 2Northeast Ohio Medical University, Rootstown, OH, 3Virginia Commonwealth University School of Medicine, Richmond, VA, 4University of California, San Diego, La Jolla, CA

Purpose/Objective(s): Gender differences in hrQOL have been reported among patients with chronic illnesses including cystic fibrosis and rheumatoid arthritis. Treatment of brain tumors (often a combination of surgery, chemotherapy, and radiation (RT)) significantly impacts hrQOL. We analyzed data from a prospective longitudinal study of hrQOL in patients receiving brain RT to understand whether patient gender impacts hrQOL at baseline (prior to RT).

Materials/Methods: This prospective study included patients with primary and metastatic brain tumors receiving intracranial RT from 2013-2017. Prior to RT, eligible patients completed a core overall hrQOL tool (EORTC QLQ C-15-PAL) and a brain tumor-specific module (QLQ-BN20). Patients repeated these questionnaires one month post-treatment and every 3-months until patient death or study withdrawal. Baseline patient data included age, gender, KPS, tumor histology, and tumor type (primary, metastasis, or recurrent disease). General linear modeling and univariate analyses were performed using statistical software. Alpha was set to 0.05 to determine significance for all analyses.

Results: 221 patients (51% male, 49% female) completed baseline surveys. The majority of patients had brain metastases (57%) while 43% had a primary brain tumor (13% low grade gliomas (WHO grade I and II), 26% high grade gliomas (WHO grade III and IV), and 4% benign/other). Age as a binary variable (>60 or <=60) was not significantly associated with hrQOL differences using both C-15-PAL and BN-20 tools (p >.05 across all domains). On univariate analysis, women reported significantly lower emotional functioning (mean difference = 9%, p = 0.002) and physical functioning (mean difference = 9%, p = 0.048), higher fatigue (mean difference = 25%, p = 0.023), higher nausea/vomiting (2.7 times higher, p = 0.007), and higher pain (1.6 times higher, p = 0.004) when compared to men using the C-15-PAL survey. Women also experienced significantly higher hair loss (4.1 times higher, p < 0.001), headaches (2 times higher, p < 0.001), communication deficits (mean difference = 58%, p = 0.015), motor dysfunction (mean difference = 50%, p = 0.033), and future uncertainty (mean difference = 44%, p < 0.001) in comparison to men using the BN-20 survey (see Table 1).

Conclusion: In this study we demonstrated significant overall and brain tumor-specific hrQOL differences between females and males, with females demonstrating significantly worse hrQOL than males in many domains prior to RT. This knowledge may be useful in the design of gender-specific interventions to improve QOL and future analyses will model these data in a multivariate longitudinal fashion.
EORTC QLQ-C15 Female : Male Mean Difference (%) p value BN-20 Female : Male Mean Difference (%) p value
Emotional functioning -9 0.002 Hair loss 418 <0.001
Physical functioning -9 0.048 Headaches 100 <0.001
Fatigue 25 0.023 Communication deficits 58 0.015
Nausea / Vomiting 272 0.007 Motor dysfunction 50 0.033
Pain 164 0.004 Future uncertainty 44 <0.001

Author Disclosure: J. Burkeen: None. T. Pan: None. Y. Dalia: None. Y. Sharifzadeh: None. D.C. Marshall: None. C. McDonald: None. J.A. Hattangadi-Gluth: Research Grant; Varian Medical Systems.

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