Open AccessChanges in Functional Performance Measures in Adults Undergoing Chemoradiation for Primary Malignant Glioma: A Feasibility Study
Author(s) -
Jones Lee W.,
Mourtzakis Marina,
Peters Katherine B.,
Friedman Allan H.,
West Miranda J.,
Mabe Stephanie K.,
Kraus William E.,
Friedman Henry S.,
Reardon David A.
Publication year - 2010
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2009-0265
Subject(s) - medicine , cohort , quality of life (healthcare) , glioma , cardiorespiratory fitness , prospective cohort study , physical therapy , cohort study , magnetic resonance imaging , radiology , nursing , cancer research
Purpose. To investigate the feasibility of longitudinal assessment of functional performance measures in newly diagnosed postsurgical malignant glioma patients. Methods. Patients with histologically confirmed, clinically stable, postsurgical, and previously untreated high‐grade glioma (HGG) or low‐grade glioma (LGG) were studied. Using a prospective design, all participants performed a cardiopulmonary exercise test with expired gas analysis to assess cardiorespiratory function (VO 2peak ) immediately following surgical resection (mean, 10 days). Additional functional outcomes were skeletal muscle cross‐sectional area (CSA) via magnetic resonance imaging, isokinetic muscle strength (isokinetic dynamometry), and body composition (air displacement plethysmography). Quality of life (QOL) was assessed by the Functional Assessment of Cancer Therapy–Brain scale. All study assessments were repeated at 6 and 24 weeks following surgery. Results. Thirty‐five patients (HGG, n = 25; LGG, n = 10) completed baseline assessments. Of these, 20 HGG (80%) and nine LGG (90%) and 15 HGG (60%) and nine LGG (90%) patients completed study assessments at 6 weeks and 24 weeks, respectively. Intention‐to‐treat analyses indicated several significant time‐by‐group interactions, with favorable improvements in functional and QOL endpoints from baseline to 24 weeks in the LGG cohort and unfavorable changes in the HGG cohort. Per‐protocol analyses including participants assessed at all three study timepoints indicated significant improvements in VO 2peak and fatigue from baseline to 24 weeks in the HGG cohort; peak workload, body composition, and muscle strength improved from baseline to 6 weeks (all p ‐values < .05). Conclusions. Longitudinal quantitative functional assessments are safe and feasible among select patients undergoing chemoradiation for primary malignant glioma. Large prospective studies investigating the clinical importance of these measures appear warranted.