Frequency and burden of potentially treatable symptoms in glioma patients with stable disease: a classical and a network approach

Background: Glioma patients experience a multitude of symptoms, impacting health-related quality of life. We aimed to assess frequency and burden of patient-reported symptoms in glioma patients with stable disease and whether patients would consider treatment. We also explored how symptoms co-occur and interact within a network.Methods: Patients rated frequency and burden and whether they would consider treatment of seventeen symptoms. Correlations between frequency, burden, and considering treatment were evaluated with Kendall’s Tau correlation coefficients. Partial correlations between symptom frequency scores were visualized as a symptom network.Results: Fifty-two glioma patients with stable disease were included (31 grade II/III, 21 grade IV tumors). The top five symptoms were fatigue, memory problems, reduced physical fitness, concentration problems, and drowsiness. Fatigue had the highest median frequency, 4.5 with an interquartile range of 2.5, on a seven-point Likert scale. More than 50% of patients experienced three or more symptoms simultaneously. In a network, symptoms seem to cluster together in a Fatigue, Cognition and Anxiety cluster. Overall, about one-third of patients would consider treatment for at least one symptom. Considering treatment correlated only moderately with frequency and burden (range of correlations 0.24-0.57 and 0.28-0.61, respectively).Conclusion: Glioma patients with stable disease often experience multiple co-occurring symptoms with a high symptom burden. Despite the high prevalence of symptoms, the inclination to undergo treatment was relatively low. The most frequent and burdensome symptoms and the way they are interrelated and cluster together could serve as a roadmap for future research on symptom management and treatment.