Association of thyroid hormone concentrations with quality of life of primary brain tumor patients: a pilot study

Abstract

Reduced triiodothyronine (T3) concentrations were implicated in worse prognosis of brain tumor patients. In this study we investigated the association of normal and abnormal thyroid hormone concentrations with health-related quality of life (HRQoL) of patients with primary brain tumors. Sixty-three patients (67% women and a mean age of 55.5 ± 13.8 years) before brain tumor surgery were evaluated for: (1) HRQoL using the EORTC questionnaire for cancer patients (QLQ-C30) and the Brain Cancer-Specific Quality of Life Questionnaire (QLQ-BN20); (2) functional status (Barthel Index); and (3) clinical disease severity. Blood samples were obtained for assessment of thyroid hormone concentrations before surgery. After adjusting for the brain tumor histological diagnosis, patients' age, gender and functional status, lower thyroid stimulating hormone (TSH) concentrations were associated with poor levels of functioning on the QLQ-C30 scales: physical functioning (β = 0.395, p < 0.001), role functioning (β = 0.334, p = 0.003) and cognitive functioning (β = 0.327, p = 0.009), and with greater QLQ-BN20 fatigue symptom severity (β = -0.406, p < 0.001). Lower free T3 concentrations were associated with worse HRQOL on the QLQ-C30 global health status (β = 0.302, p = 0.017), emotional functioning (β= 0.422, p < 0.001) and cognitive functioning (β= 0.259, p = 0.042) domains, and with greater symptom severity on the QLQ-BN20 fatigue (β = -0.238, p = 0.041), motor dysfunction (β = -0.283, p = 0.013) and weakness of legs (β = -0.269. p = 0.027) domains. In conclusion, reduced T3 and TSH hormone concentrations are associated with impaired emotional and physical aspects of HRQoL of primary brain tumor patients independent of brain tumor histological diagnosis, patients' age, gender and functional status. Assessment for thyroid axis dysfunction should be addressed and appropriately managed in neuro-oncology patient care.

Keywords: Brain tumor; Glioma; Quality of life; Thyroid hormones; Tri-iodothyronine.