P01.081 Can psychological profile change during RT and influence survival in patients affected by high grade gliomas? Final report of a prospective study

Abstract

BACKGROUND: Radiotherapy has an impact on psychological functioning also in patients with primary brain tumor (BT). In these patients depression and anxiety have been found to be as high as 62.5% with 52% of distress. In literature is known that non-depressed glioblastoma patients show longer survival than depressed patients. Aim of this study is to evaluate BT patients' psychological profile, its evolution during/after RT and its relationship with survival. MATERIAL AND METHODS: Consecutive patients with BT who underwent RT with radical intent were included. Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Cancer Therapy (FACT-Br) were used to evaluate emotional distress, mood and quality of life, respectively. The tests were self-administered at the beginning (t0), middle (t1), end (t2) of RT course and three months after the end of RT (t3). Statistical analysis of time variations in tests' scores was performed by the Wilcoxon signedrank test while the relationship between clusters of psychological profile and dicothomic survival performance by a Fisher's exact test. Overall Survival (OS) was investigated with Kaplan Meier curves and Log-Rank test. RESULTS: Sixty patients (34 male 26 female) with median age of 55 yrs (range 20-73 yrs) were included between January 2016 and April 2017. Radiotherapy was post-operative in all patients and was delivered up to a median total dose of 60 Gy (range 54-66). Forty-seven out of sixty (78.3%) patients received concurrent Temozolomide (TMZ). All patients underwent the t0, t1 and t2 evaluation. Tests after three months (t3) are available for 48 (80%) patients. In patients with psychological wellbeing at t0 (“easy patients”) (DT<4;HADS<14) there is no significant statistical evidence, at the Wilcoxon test, of any change over time. In patients who were distressed and anxious/depressed (“uneasy patients”)(DT≥4 and/or HADS≥14)(N=33) we found a statistically significant improvement in DT and HADS when comparing t1vs t2 (p<0.001, at Wilcoxon). Even emotional and functional wellbeing subscales of FACT-Br improved over time (t0 Vs t3) (p<0.001 at Wilcoxon). for GBM patients, the OS was related to psychological profile (“easy patients” had longer survival than “uneasy patients”) with a p-value equal to 0.002 at the log-rank test on Kaplan Meier curves. Remarkably, there is no evidence of correlation between “easy”/“uneasy” condition at t0 and age/histology/sex or residual. CONCLUSION: Our data suggests that psychological profile improves in “uneasy patients” and confirms to be a candidate for predicting OS in patients affected by glioblastoma.