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Factors associated with long-term functional outcomes, psychological sequelae and quality of life in persons after primary brain tumour

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Abstract

To examine factors impacting long-term functional outcomes and psychological sequelae in persons with primary brain tumours (BT) in an Australian community cohort. Participants (n = 106) following definitive treatment for BT in the community were reviewed in rehabilitation clinics to assess impact on participants’ current activity and restriction in participation, using validated questionnaires: Functional Independence Measure (FIM), Perceived Impact Problem Profile (PIPP), Depression Anxiety Stress Scale, Cancer Rehabilitation Evaluation System–Short Form and Cancer Survivor Unmet Needs Measure. Mean age of the participants was 51 years (range 21–77 years), majority were female (56 %) with median time since BT diagnosis 2.1 years and a third (39 %) had high grade tumours. Majority showed good functional recovery (median motor FIM score 75). Over half reported pain (56 %), of which 42 % had headaches. Other impairments included: ataxia (44 %), seizures (43 %); paresis (37 %), cognitive dysfunction (36 %) and visual impairment (35 %). About 20 % reported high levels of depression, compared with only 13 % in an Australian normative sample. Two-third (60 %) participants reported highest impact on the PIPP subscales for psychological wellbeing (scores of >3 on 6-point scale) and participation (45 %). Factors significantly associated with poorer current level of functioning and wellbeing included: younger participants (≤40 years), recent diagnoses, aggressive tumour types and presence of pain. No significant differences in scale scores were found across various treatments (surgery, chemotherapy or radiotherapy) on outcomes used. Rehabilitation for BT survivors is challenging and requires long-term management of psychological sequelae impacting activity and participation. More research into participatory limitation is needed to guide treating clinicians.

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Acknowledgments

We would like to thank all brain tumour participants in the study. We thank Dr L Ng for ethics submission, Ms L Oscari and Drs I Rajapaksa & C Mackenzie for their assistance with interviews and follow-up, and T Khan for data entry. The above mentioned persons were informed and approved this acknowledgement. F. Khan received the Clinical Research Fellowship granted by Victorian Cancer Agency. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organisation with which the authors are associated.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Royal Melbourne Hospital Ethical Committee and informed consent was obtained from all the subjects.

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Authors and Affiliations

  1. Department of Rehabilitation, Royal Melbourne Hospital, 34-54 Poplar Road, Parkville, VIC, 3052, Australia

    Fary Khan & Bhasker Amatya

  2. Department of Medicine, Dentistry & Health Sciences, University of Melbourne, Parkville, VIC, Australia

    Fary Khan

  3. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Fary Khan

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  1. Fary Khan
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  2. Bhasker Amatya
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Correspondence to Fary Khan.

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Khan, F., Amatya, B. Factors associated with long-term functional outcomes, psychological sequelae and quality of life in persons after primary brain tumour. J Neurooncol 111, 355–366 (2013). https://doi.org/10.1007/s11060-012-1024-z

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  • DOI: https://doi.org/10.1007/s11060-012-1024-z

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