Age and sex as risk factors for health-related quality of life outcomes in patients with glioma: a CODAGLIO 2.0 analysis

BACKGROUND: We assessed the clinical relevance of age and sex as risk factors for health-related quality of life (HRQoL) in patients with adult-type diffuse glioma. MATERIALS AND METHODS: The CODAGLIO 2.0 database contains 16 randomized trials from 5369 patients with glioma. Patients' HRQoL was assessed using EORTC QLQ-C30 and QLQ-BN20 questionnaires. In 8 HRQoL scales, we compared mean HRQoL at baseline with the general population and evaluated factors associated with HRQoL over time using linear mixed models (LMMs). We used the anchor-based minimally important difference to interpret clinically relevant changes. RESULTS: We included 4301 patients with baseline HRQoL followed up to 3 months. Compared to the general population, patients with glioma at baseline had statistically and clinically relevant worse HRQoL, which was still evident after stratifying by age and sex groups. In LMMs, compared to patients aged ≤60 years, those >60 years had statistically significant associations with worse physical functioning: -2.40 (95% confidence interval [CI] -4.14 to -0.71), better social: 4.88 (2.68-7.30) and role: 3.79 (1.39-6.16) functioning, and less fatigue: -3.43 (-5.44 to -1.33) and pain: -4.56 (-6.18 to -2.93). Compared to men, women had statistically significant associations with worse physical and social functioning and more fatigue and pain. Associations between age, sex, and HRQoL were not clinically relevant. Performance status had clinically relevant associations in 5/8 scales. CONCLUSION: Patients with glioma have clinically relevant worse HRQoL compared to the general population. There are statistically but not clinically significant associations between age, sex, and certain HRQoL scales.