Prognostic value of health‐related quality of life for death risk stratification in patients with unresectable glioblastoma

Brice Paquette (1) , Dewi Vernerey (1) , Bruno Chauffert (2) , Sandrine Dabakuyo (3) , Loic Feuvret (4) , Luc Taillandier (5, 6) , Didier Frappaz (7) , Hervé Taillia (8) , Roland Schott (9) , François Ducray (10) , Michel Fabbro (11) , Isabelle Tennevet (12) , François Ghiringhelli (3) , Jean‐sébastien Guillamo (13) , Xavier Durando (14) , Daniel Castera (15) , Marc Frenay (16) , Chantal Campello (17) , Cécile Dalban (3) , Jérome Skrzypski (3) , Olivier Chinot (18) , Amélie Anota (1) , Franck Bonnetain (1)

1 CEF2P / CARCINO - Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181)
2 HEMATIM - HEMATIM - Hématopoïèse et immunologie - UR UPJV 4666
3 UNICANCER/CRLCC-CGFL - Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon]
4 CHU Pitié-Salpêtrière [AP-HP]
5 CRAN - Centre de Recherche en Automatique de Nancy
6 Service de neurologie [CHRU Nancy]
7 Centre Léon Bérard [Lyon]
8 HIA VAL DE GRACE - Oncologie - Service d'Oncologie
9 CRLCC Paul Strauss - Centre Paul Strauss
10 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
11 CRLC Val d'Aurelle-Paul Lamarque
12 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
13 Service de Neurologie [CHU Caen]
14 UNICANCER/CJP - Centre Jean Perrin [Clermont-Ferrand]
15 Clinique Saint Pierre, Perpignan
16 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
17 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
18 TIMONE - Hôpital de la Timone [CHU - APHM]

Glioblastoma is the most common malignant brain tumor in adults. Baseline health‐related quality of life (HRQoL) is a major subject of concern for these patients. We aimed to assess the independent prognostic value of HRQoL in unresectable glioblastoma (UGB) patients for death risk stratification. One hundred and thirty‐four patients with UGB were enrolled from the TEMAVIR trial. HRQoL was evaluated at baseline using the EORTC QLQ‐C30 and BN20 brain cancer module. Clinical and HRQoL parameters were evaluated in univariable and multivariable Cox analysis as prognostic factors for overall survival (OS). Performance assessment and internal validation of the final model were evaluated with Harrel's C‐index, calibration plot, and bootstrap sample procedure. Two OS independent predictors were identified: future uncertainty and sensitivity deficit. The final model exhibited good calibration and acceptable discrimination (C statistic = 0.63). The internal validity of the model was verified with robust uncertainties around the hazard ratio. The prognostic score identified three groups of patients with distinctly different risk profiles with median OS estimated at 16.2, 9.2, and 4.5 months. We demonstrated the additional prognostic value of HRQoL in UGB for death risk stratification and provided a score that may help to guide clinical management and stratification in future clinical trials.

Domaines: Sciences du Vivant [q-bio]; Cancer

Brice Paquette, Dewi Vernerey, Bruno Chauffert, Sandrine Dabakuyo, Loic Feuvret, et al.. Prognostic value of health‐related quality of life for death risk stratification in patients with unresectable glioblastoma. Cancer Medicine, 2016, 5 (8), pp.1753-1764. ⟨10.1002/cam4.734⟩. ⟨hal-03036055⟩