1. Health-related quality of life in outpatients with primary central nervous system lymphoma after radiotherapy and high-dose methotrexate chemotherapy
- Author
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Shin Nakajima, Yasuji Miyakita, Ruriko Miyahara, Makoto Ohno, Toshiyuki Fujinaka, Yoshitaka Narita, Masamichi Takahashi, Yoshiko Okita, Yonehiro Kanemura, and Masahiro Nonaka
- Subjects
Cancer Research ,medicine.medical_specialty ,Chemotherapy ,Multivariate analysis ,business.industry ,medicine.medical_treatment ,Primary central nervous system lymphoma ,Articles ,medicine.disease ,humanities ,Surgery ,Leukoencephalopathy ,Radiation therapy ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Quality of life ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Methotrexate ,business ,030217 neurology & neurosurgery ,Chemoradiotherapy ,medicine.drug - Abstract
Chemoradiotherapy for primary central nervous system lymphoma (PCNSL) is associated with a considerable risk of long-term neurotoxicity. The present study aimed to assess the health-related quality of life (HRQOL) of outpatients with PCNSL who have received radiotherapy and high-dose methotrexate (HDMTX) chemotherapy, and to determine the factors that cause a decline in HRQOL and interfere with home living. A total of 37 patients were surveyed 0.9–14.2 years after their initial diagnosis and treatment. Each patient completed a multi-part HRQOL questionnaire that was used to examine the associations of HRQOL scores with leukoencephalopathy, Karnofsky performance status (KPS) scores, age, history of recurrence and HDMTX-based chemoradiotherapy. The results demonstrated that the history of recurrence, number of cycles of MTX chemotherapy and age affected the development of leukoencephalopathy. Reductions in KPS score were associated with a history of recurrence (P=0.03), but not with leukoencephalopathy (P=0.8). KPS score, leukoencephalopathy and age were significantly associated with a decline in HRQOL score. A decline in the HRQOL associated with a reduction in KPS score was also observed by multivariate analyses. Deterioration of the HRQOL among outpatients with PCNSL post-chemoradiotherapy was significantly associated with older age (≥66 years) and decreased KPS score. Older patients with a history of recurrence had a higher risk for deteriorated QOL due to development of leukoencephalopathy. Therefore, it is recommended that clinicians monitor the KPS score among outpatients with PCNSL. QOL examination for older patients with a lower KPS score was found to be particularly important for identifying any obstacles for home living.
- Published
- 2016