Evaluating Clinical and Sociodemographic Risk for Symptom Burden Associated Interference With Daily Functioning in the Primary Brain Tumor Patient Population

Introduction

Symptom burden associated with interference in daily functioning is worse in those with progression or higher-grade glial tumors. This exploratory study aims to identify factors associated with its severity in a diverse cross-sectional cohort of 566 brain tumor patients enrolled in a natural history study (NCT03251989, PI: T.S. Armstrong).

Methods

Sociodemographic and clinical data and self-reported activity-related interference (work, general activity, walking), mood-related interference (relations with others, enjoyment of life, mood) were reported via the MD Anderson Symptom Inventory-Brain Tumor. Activity and mood-related interference mean scores ≥ 2 were categorized as moderate–severe. Logistic regression assessed univariate associations with moderate–severe interference. Characteristics significant in the univariate analysis were included in a multivariable analysis.

Results

This patient sample had a median age of 48 years (18–85), was mostly male (57%), with a high-grade tumor (73%), glioblastoma (39%), and tumor recurrence (49%). Risk factors for moderate–severe activity-related interference included: ≥ 2 surgeries (OR = 1.64, 95% CI [1.10, 2.44], p = 0.015), ependymoma (OR = 2.59, 95% CI [1.21–5.53], p = 0.014), and childhood in a rural area (OR = 1.74, 95% CI [1.15–2.63] p = 0.009). Risk factors for moderate–severe mood-related interference included tumor progression (OR = 2.02, 95% CI [1.21–3.36], p = 0.009).

Conclusion

Patient reported interference with daily physical functioning is associated with sociodemographic and disease-related characteristics and notably worse mood-related interference in those with progression. Future studies should include social determinants of health and change over time to identify and plan interventions for those at risk.