Neurocognitive state and quality of life of patients with glioblastoma in Mediterranean countries: a systematic review.

Background: Gliomas are the most common primary tumors of the central nervous system (CNS). The most common subtype of glioma in adults is grade IV astrocytoma, known as glioblastoma (GB) multiforme. Despite advances in treatment, GB remains a lethal tumor with a poor prognosis, and patients face serious quality of life (QoL) issues. Its poor prognosis is a real public health problem. The present study aimed to determine the exact neurocognitive status and QoL in patients with GB in the Mediterranean region and the different predictive factors responsible for their deterioration.

Methods: This systematic review was conducted in accordance with PRISMA guidelines. The protocol was registered in the PROSPERO (Identifier: CRD42020188936). The following databases have been independently searched by 2 authors: PubMed, Science Direct, Scopus and Google Scholar.

Results: Thirteen studies were selected (n=13). Four studies (n=4) focused solely on cognitive assessment, five studies (n=5) focused on quality-of-life assessment, and four (n=4) were simultaneously assessed QoL and neurocognitive status. The majority of studies in this review use (Mini-Mental State Examination, MMSE) for an overall cognitive assessment (n=5), other studies use specific batteries for an in-depth assessment of cognitive functions (n=3). The study revealed several affected functions: short and long-term memory, executive functions (EFs), and visuo-constructive abilities. Scale of European Organization for Research and Treatment of Cancer and the Functional Assessment of Cancer Therapy are among the most widely used instruments for assessing QoL. For factors influencing neurocognitive status and QoL, the present review found that: The Karnofsky Performance Scale (KPS), tumor location, age, sex and type of treatment are the most identified. Other studies have reported other factors, such as tumor progression, development of emotional distress, and coping strategies adopted.

Discussion: We conclude that there were many changes in patients with GB during the course of the disease and that most of them were related to age and disease progression. The use of coping strategies based on social support has a positive impact on the QoL.