P05.57 Health-related quality of life in patients with large skull base benign meningiomas treated with proton therapy

Abstract

Background

Thanks to their distinct physical properties proton therapy (PT) offers a superior dose distribution than photon radiation therapy. For benign skull base tumors such dose sparing can be harnessed to minimize the risk of side effects ultimately reducing the possible detrimental effect on quality of life (QoL). Aim of this report is to describe QoL in patients (pts) with large skull base benign meningiomas treated with PT.

Material and Methods

Thirty-three pts with large skull base meningiomas were treated with PT between January 2015 and February 2018. Median age was 53 years (range, 28–82) while KPS ranged between 60 and 100 (median 90). All patients received PT for residual, progressive or non-operable lesions. Newly diagnosed tumors received total dose of 50 GyRBE (RBE: relative biologic effectiveness) while progressing meningiomas 54 GyRBE, in 2 GyRBE per fraction. Health-related (HR) QoL was assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)--C30 and EORTC Quality of Life Questionnaire Brain Cancer Module (QLQ-BN20). Subscales within the EORTC QLQ-C30 include five functional scales (physical, role, emotional, cognitive, and social), three symptoms scales (nausea, vomiting, and fatigue), six single-item scales (insomnia, appetite loss, constipation, diarrhea, dyspnea, and financial effect of tumor/treatment) and global QoL. The BN20 is specifically developed for brain patients and assessed visual disorders, motor function, communication deficit, various disease symptoms, treatment, toxicity and future uncertainty. The patients completed the EORTC questionnaires before starting PT, the last day of PT and every follow-up consult until progression of disease.

Results

At median follow-up time of 9 months (range, 3–37), all pts completed the questionnaires at baseline as well as thereafter. Currently all pts are free of disease progression. The treatment was associated with improvement or stability in most of the preselected HRQoL domains. Global health improved over time with a maximum difference between baseline and 9-months follow-up. Also social functioning and motor dysfunction improved over time. Cognitive and emotional functioning, as well as fatigue remained stable during the analysis.

Conclusion

PT is a safe treatment with a favourable effect on HRQoL in pts with large skull base benign meningiomas