Maximizing Quality of Life From the Get-Go in Neuro-Oncology Care

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.