ArticleJournal of neuro-oncology2026
Health-related quality-of-life of WHO grade 4 astrocytoma patients receiving alternating electrical field therapy: a prospective real-world multi-centre study.
Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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23 authors.
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Abstract
purposeAlternating electric fields (AEF) therapy has been shown to improve the overall survival of patients with WHO grade 4 astrocytoma. Few have explored its impact on health-related quality-of-life (HRQoL) and caregiver stress.
methodsThis was a prospective, multi-centre, registry-based study of adult patients with WHO grade 4 astrocytoma who received either AEF plus temozolomide chemoradiotherapy (AEF + CRT) or CRT alone, with EORTC QLQ-C30/BN20, CSI, and HK-MoCA assessments at baseline and every three months. The primary outcome was the global QLQ-30 score at 3 months after CRT. Secondary outcomes included the QLQ-30 functional score, symptom scores and the caregiver stress index (CSI) at 3 months.
results88 patients, 48 AEF + CRT and 40 CRT-alone, were reviewed. The mean AEF duration was 10 ± 8 months. At 3 months, AEF + CRT patients had significantly lower global QLQ-C30 scores than CRT-alone patients (44 ± 22 vs. 66 ± 20; between-group difference 22 points; p < 0.001), exceeding the established minimally important difference of 4-6 points for glioma. On multivariable analysis, AEF therapy (adjusted OR 0.09, 95% CI 0.006-0.7) and preoperative KPS ≥ 80 (adjusted OR 0.09, 95% CI 0.01-0.5) were associated with lower odds of high global QoL (≥ 60). Functional and symptom scores were comparable between groups, apart from higher scalp pruritus in AEF + CRT patients. Mean caregiver CSI scores remained < 7 at all time points.
conclusionIn this prospective real-world cohort of Chinese patients with WHO grade 4 astrocytoma, AEF therapy was independently associated with a reduction in global HRQoL at 3 months compared with CRT alone, while functional and symptom domains and caregiver stress remained largely stable. These data should inform shared decision-making when weighing the survival benefit of AEF against its short-term QoL burden, especially in subtropical climates where scalp-related adverse effects may be more pronounced.
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