Improved health-related quality of life after rehabilitation in patients with brain tumors is not affected by tumor type.

Abstract

Background: The effect of rehabilitation therapy on health-related quality of life (HRQOL) among patients with brain tumors has not been fully investigated.

Aim: This study aimed to evaluate the effect of rehabilitation therapy on HRQOL among patients with brain tumors using the HRQOL index. We also examined factors that influenced changes in HRQOL, including differences in brain tumor type.

Design: Prospective cohort study.

Setting: University Medical and Dental Hospital.

Population: Patients with brain tumors aged 20 years or older undergoing rehabilitation therapy were included. Patients with cognitive decline, aphasia, or poor general condition who had difficulty answering HRQOL questions were excluded.

Methods: The EuroQol-5 Dimension 5-Level (EQ-5D-5L), EORTC Quality of Life Questionnaire Core 30 (QLQ-C30), and EORTC Quality of Life Questionnaire Brain Cancer Module (BN20) were used to assess HRQOL before and after rehabilitation treatment. Brain tumor type was classified into five groups: World Health Organization (WHO) grade 1, WHO grade 2/3, WHO grade 4, primary central nervous system lymphoma, and metastatic brain tumor. We compared EQ-5D-5L index scores and QLQ-C30 and BN20 scores before and at the end of rehabilitation. Multiple regression analysis was used to examine factors affecting changes in EQ-5D-5L index score (EQ-5D-5L gain).

Results: In total, 112 patients participated in this study. The median EQ-5D-5L index score significantly improved from 0.698 before rehabilitation to 0.772 at the end of rehabilitation (P<0.001, r=0.46). QLQ-C30 and BN20 scores showed significant improvement in physical functioning, global health status, pain, and motor dysfunction (P<0.001, r>0.3). Multiple regression analysis revealed that recurrence (β=-0.191, P=0.037) and baseline EQ-5D-5L index score (β=-0.595, P<0.001) affected EQ-5D-5L gain, whereas differences in brain tumor type did not.

Conclusions: HRQOL among patients with brain tumors improved at the end of rehabilitation therapy compared with before therapy. Furthermore, the EQ-5D-5L index score gain was not affected by brain tumor type.

Clinical rehabilitation impact: These results suggest rehabilitation therapy may contribute to improved HRQOL irrespective of brain tumor type.