NCOG-55. Quality of life in patients receiving adjuvant hypofractionated stereotactic radiotherapy with concurrent and adjuvant temozolomide in newly diagnosed GBM

BACKGROUND Glioblastoma multiforme (GBM) is an aggressive cancer in adults primarily treated with maximal safe resection followed by postoperative radiotherapy with concurrent and adjuvant temozolomide. AIM To assess the quality of life in patients treated with hypofractionated stereotactic radiotherapy (HFSRT) compared to conventional radiotherapy in adjuvant setting. METHODS Fifteen adult patients diagnosed with GBM with ECOG performance status of 0-1were included in the study from August 2019 to April 2021. All patients underwent maximal safe resection. Seven patients received adjuvant HFSRT at a dose of 42Gy in six fractions delivered on alternate days and eight patients received conventional radiotherapy at a dose of 60Gy in 30 fractions over six weeks. Both arms received concurrent and adjuvant temozolomide. The EORTC QLQ-C30 and QLQ-BN 20 questionnaires were used to assess health related quality of life at baseline and three, six- and nine-months post treatment. The hospital anxiety depression scale (HADS) and the zarit burden interview (ZBI) for assessing anxiety/depression in patients and caregiver burden, respectively. RESULTS Among the five functional scales in QLQ-C30, patients who received HFSRT had higher scores for role and social functions in the first six months compared to patients who received conventional treatment. Among the symptom scales, there was no significant difference among the two treatment groups. The QLQ-BN20 showed higher scores for future uncertainty, drowsiness and bladder control in patients who received HFSRT while those who received conventional RT had higher symptom scores for headache, leg weakness, hair loss and itching skin. The HADS and ZBI scores were not different among the two groups. CONCLUSION Adjuvant hypofractionated stereotactic radiotherapy with concurrent and adjuvant temozolomide can result in a better quality of life in patients with GBM especially within the first six months of treatment completion.