Abstract
INTRODUCTION: Health-related quality of life (HRQoL) is increasingly recognised as an important component of neuro-oncology assessment. The EORTC QLQ-C30 is a well-validated instrument for measuring global health domains and cancer-related symptoms. On this background we sought to evaluate questionnaire symptom reporting as compared to standard clinical assessment. METHOD: Patients presenting for initial assessment in neurosurgical oncology clinic were asked to complete the QLQ-C30 and BN20 brain cancer module questionnaires prior to their appointment. Clinician reported symptoms were determined retrospectively from outpatient clinic letters. Statistical significance was determined using paired t-test and Fisher's exact test. RESULTS: A total of 181 patients were included in the analysis (96 male, 86 female; median age 61). Commonest diagnoses included high-grade glioma (n = 63; 34.6%), metastatic disease (n = 33; 18.1%) and low-grade glioma (n = 29; 15.9%). A higher average number of symptoms was reported by patients (8.2 ± 0.3) compared to clinicians (2.1 ± 0.1; p < 0.0001). Reporting rate for all symptoms was significantly higher from the questionnaire (all p < 0.002) with the exception of seizures which had a higher reporting rate from clinician review (p < 0.0001). Positive symptoms showing the highest concordance included motor dysfunction (43.0%), communication deficit (30.4%) and visual disorder (29.5%). CONCLUSION: Measuring HRQoL with the QLQ-C30 and BN20 enabled detection of more presenting symptoms than by clinician review alone, with concordance highest for gross neurological deficits. Routine collection of HRQoL data thus adds a further dimension to clinical assessment that enhances and complements current practice.