Abstract
AB011. A propensity-score matched prospective study on the impact of tumour treating fields (TTF) on overall survival and quality of life in newly diagnosed WHO grade 4 astrocytoma patients
Desiree K. K. Wong1,2, Peter Y. M. Woo1,3, Sandy W. Lam1, Joyce S. W. Chow1, Lai-Fung Li1, Natalie M. W. Ko1, Tony K. T. Chan1, Sui-To Wong1, Michael W. Y. Lee1, Fung-Ching Cheung1, Danny T. M. Chan1
1The Hong Kong Neuro-Oncology Society, Hong Kong, China;
2Department of Neurosurgery, Queen Elizabeth Hospital, Hong Kong, China;
3Department of Neurosurgery, Prince of Wales Hospital, Hong Kong, China
Correspondence to: Desiree K. K. Wong, MBBS. The Hong Kong Neuro-Oncology Society, Hong Kong, China; Department of Neurosurgery, Queen Elizabeth Hospital, 30 Gascoigne Rd., Kowloon, Hong Kong, China. Email: desiree.kk.wong@gmail.com.
Background: World Health Organization (WHO) grade 4 astrocytoma is a high-grade brain tumour in adults. Tumour treating fields (TTF) has been shown to improve overall survival (OS). Few studies have explored quality-of-life (QoL) in these patients. This study aims to assess the QoL of TTF patients and OS.
Methods: This was a prospective multicenter study of adult patients diagnosed with WHO grade 4 astrocytoma from 2018 to 2023 receiving TTF for >1 month after completing standard therapy. A propensity-score matched comparison with a 1:2 ratio with historical control was performed for OS analysis. The patients completed European Organisation for Research and Treatment of Cancer (EORTC) QLQ-30/BN20 questionnaires before TTF and at 3-month interval. Primary outcomes included OS, and secondary outcomes included QoL and TTF-associated adverse effects at 3 months.
Results: A total of 141 patients were reviewed, with TTF patients (n=47, 33%) and propensity-score matched controls (n=94). The mean duration of TTF use was 10±8 months. The mean age of the TTF group was 54±13 years, and for the control group 52±13 years. Sixty percent (n=28) were male, similar to the control group with 71% (n=67) (P=0.16). Seventy-two percent of TTF patients had preoperative Karnofsky Performance Scale (KPS) score ≥80, while controls had 70% (P=0.79). Five (11%) TTF patients and 8 (9%) controls were IDH1 mutant (P=0.70). Twenty (43%) TTF patients and 42 (45%) controls were O6-methylguanine-DNA methyltransferase promoter (pMGMT) methylated (P=0.81). Twenty-one (45%) of TTF patients and 55 (59%) of controls had gross total resection (P=0.72). After adjusting for independent predictors for OS, the median OS of the TTF group was 22.4 months [interquartile range (IQR): 18.6–26.5 months], significantly longer than the control group (17.2 months; IQR: 12.1–22.3 months) (log-rank test: P=0.01). Forty-seven TTF patients and 40 control patients completed EORTC questionnaires. There was no difference for EORTC functional and symptom scores between the TTF and control group [P=0.45, analysis of variance (ANOVA)] at 3 months. Thirty-two (67%) of TTF patients reported associated RTOG grade I scalp dermatitis.
Conclusions: TTF for WHO grade 4 astrocytoma patients is an independent predictor for OS. QoL between the groups was similar, and overall QoL over time for TTF patients was not affected. TTF is a novel and effective outpatient treatment with minimal adverse effects.
Keywords: Tumour treating fields (TTF); glioblastoma; quality-of-life (QoL); survival; propensity-score
Acknowledgments
The authors thank to Ms Larissa Lai for contributions to the poster presentation.
Funding: None.
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab011/coif). The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and approved by Kowloon Central Cluster Institutional Review Board (IRB No. KCC/KEC-2019-0245). Written consent was obtained from the patients.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
Cite this abstract as: Wong DKK, Woo PYM, Lam SW, Chow JSW, Li LF, Ko NMW, Chan TKT, Wong ST, Lee MWY, Cheung FC, Chan DTM. AB011. A propensity-score matched prospective study on the impact of tumour treating fields (TTF) on overall survival and quality of life in newly diagnosed WHO grade 4 astrocytoma patients. Chin Clin Oncol 2024;13(Suppl 1):AB011. doi: 10.21037/cco-24-ab011
