Maximizing Quality of Life From the Get-Go in Neuro-Oncology Care
Treatment-related toxicities during neuro-oncology therapy appear well managed with dose modifications and treatment cycle holds.
The goal of preserving quality of life (QOL) and extending the lives of patients with brain tumors remains “front and center” in neuro-oncology care, according to Sylvia Kurz, MD, PhD.
Kurz, an associate professor of neurology (neuro-oncology) as part of the Chênevert Family Brain Tumor Center at Smilow Cancer Hospital and Yale Cancer Center, spoke with CancerNetwork® about key considerations for optimizing QOL and mitigating treatment-related toxicities that may occur among patients who undergo therapy for high-grade gliomas and other brain cancers. She stated that toxicities such as bone marrow suppression or chemotherapy-associated liver toxicity are typically manageable with strategies including dose modifications and symptomatic care.
In the neuro-oncology field, Kurz stated that clinicians typically think about potential symptoms and focus on the quality of care from the get-go. Additionally, she emphasized that severe long-term complications were usually rare among patients who received treatment for brain tumors.
Transcript:
The guidepost in neuro-oncology care in general is to maximize quality of life at any given time point. At this point, for many of these illnesses, including the high-grade gliomas, we’re not going for a cure, but the goal is to extend life and preserve quality of life as much as we can. That should be front and center for any treatment decisions.
Treatment-related toxicities in today’s neuro-oncology medicine probably [include] bone marrow suppression, kidney or liver toxicity from various forms of chemotherapies, and then the immunotherapy-related [adverse] effects. They are generally well managed with dose modifications, holding cycles of treatments, or symptomatic measures or care. Another big point of treatment-related toxicities is radiation-associated toxicities, where we use a drug called bevacizumab [Avastin] to help patients feel better and improve neurological symptoms.
The key consideration here is to always think about symptoms in patients and focus on quality of care from the get-go. I would also say that this is typically accomplished, and patients do as well as they can. Long-term severe complications are relatively rare in our field.
