Analysis of Quality of life in Brain tumour patients pre and post radiotherapy
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Abstract Background: The study of quality of life in patients with brain tumours during and after radiation therapy can aid in the development of effective interventional therapies for a variety of symptoms. Aim : An observational prospective follow-up study using the EORTC QLQ-C30/BN20 questionnaire to investigate the parameters related with quality of life in brain tumour patients at baseline, six weeks, three months, and six months after radiotherapy. Materials and methods: The prospective observational follow-up study was conducted over a period of 12 months in the Department of Radiation Oncology at Himalayan Institute of Medical Sciences (HIMS), Swami Rama Himalayan University, Jollygrant, Dehradun, among 45 consecutive cases of brain tumour presented over a one-year period. Complete medical history, physical examination, systemic examination (including neurological examination and baseline cognitive assessment), complete hemogram and renal function test, MRI brain, Biopsy proven primary neoplasm, Performance status was assessed using the KPS scale, and the source of proforma was the European organisation for research and treatment of quality of life and mini mental status examination. Results and conclusion: Both high grade and low had poor mean scores in cognitive functioning , emotional functioning . High grade glioma showed more symptoms of motor dysfunction (p<0.019), communication deficit (p<0.006) .The mean scores of physical functioning , role functioning , and social functioning were better in low grade gliomas. With respect to QLQ C-30/BN 20 domains , High grade glioma patients showed more symptom score such as headache (p<0.01) , Nausea and vomiting (p<0.003). Karnofsky performance status showed significant associations with all the functional scales. The patients treated with radical chemoradiation therapy showed significant correlation with role functioning (p<0.004) and improved pain score and fatigue compared to hypofractionated radiation therapy in brain tumor patients. Quality of life in Functional and Symptom scale scoring, in patients undergoing treatment for brain tumor, deteriorated significantly after treatment and gradually improved with time, as assessed on further follow up at 3 months and 6 months .
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Analysis of Quality of life in Brain tumour patients pre and post radiotherapy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Analysis of Quality of life in Brain tumour patients pre and post radiotherapy pooja kalra, MEENU gupta, viney kumar, vipul nautiyal This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8178133/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The study of quality of life in patients with brain tumours during and after radiation therapy can aid in the development of effective interventional therapies for a variety of symptoms. Aim : An observational prospective follow-up study using the EORTC QLQ-C30/BN20 questionnaire to investigate the parameters related with quality of life in brain tumour patients at baseline, six weeks, three months, and six months after radiotherapy. Materials and methods: The prospective observational follow-up study was conducted over a period of 12 months in the Department of Radiation Oncology at Himalayan Institute of Medical Sciences (HIMS), Swami Rama Himalayan University, Jollygrant, Dehradun, among 45 consecutive cases of brain tumour presented over a one-year period. Complete medical history, physical examination, systemic examination (including neurological examination and baseline cognitive assessment), complete hemogram and renal function test, MRI brain, Biopsy proven primary neoplasm, Performance status was assessed using the KPS scale, and the source of proforma was the European organisation for research and treatment of quality of life and mini mental status examination. Results and conclusion: Both high grade and low had poor mean scores in cognitive functioning , emotional functioning . High grade glioma showed more symptoms of motor dysfunction (p<0.019), communication deficit (p<0.006) .The mean scores of physical functioning , role functioning , and social functioning were better in low grade gliomas. With respect to QLQ C-30/BN 20 domains , High grade glioma patients showed more symptom score such as headache (p<0.01) , Nausea and vomiting (p<0.003). Karnofsky performance status showed significant associations with all the functional scales. The patients treated with radical chemoradiation therapy showed significant correlation with role functioning (p<0.004) and improved pain score and fatigue compared to hypofractionated radiation therapy in brain tumor patients. Quality of life in Functional and Symptom scale scoring, in patients undergoing treatment for brain tumor, deteriorated significantly after treatment and gradually improved with time, as assessed on further follow up at 3 months and 6 months . Brain Tumour CT MRI Quality of life Radiotherapy Introduction Primary brain tumors comprises 2% of all malignancies in the adult patient population are the 10th leading cause of death for men and women 1 . The most commonly occurring malignant brain tumour was glioblastoma . There were 81,246 deaths attributed to malignant brain and other CNS tumors between 2013 and 2018. This represents an average annual mortality rate of 4.42. The 5-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 23.5% and for benign and other CNS tumor was 82.4% 2 . According to the GLOBOCAN 2018 ,India overall estimated mortality in was 24,003 cases 3 . Primary brain tumors are subdivided into benign and malignant types and classified according to the World Health Organization (WHO) Classification, ranging from, WHO grade I meningioma to WHO grade IV glioblastoma. Symptoms vary according to the location of the tumor and include paralysis or sensory disturbances, increased intracranial pressure, personality changes, epileptic seizures, cognitive impairments, and visual disorder. All these symptoms may markedly affect health-related quality of life (HRQOL) 6 . Patients with primary brain tumors face serious challenges to their QOL 7 . They have difficulties with general symptoms such as headache, anorexia, nausea, seizures, and insomnia. These patients also face symptoms secondary to focal neurological deterioration, including motor deficits, personality changes, cognitive deficits, aphasia, or visual field defects 8 .. For evaluation of QOL, the EORTC QLQ-C30 questionnaire and the QLQ-BN20 questionnaire are used. 1 There are limited clinical guidelines available regarding management of symptoms and factors affecting quality of life in brain tumors. We henceforth conducted an observational prospective follow up study to assess the factors associated with Quality Of life in brain tumor patients using EORTC QLQ-C30/BN20 questionnaire at baseline, six weeks, three months and six months. Materials and Methods The prospective observational follow up study was conducted in the Department of Radiation Oncology, over a period of 12 months, among 45 consecutive cases presented over a period of one year with brain tumour. Subjects were recruited from OPD of Radiation Oncology with histopathologically proven diagnosis of brain tumor after taking written and informed consent. All patients > 10 years of age belonging to either gender, histologically proven cases of brain tumor, life expectancy > 3 months, KPS > 70% and patients with no evidence of synchronous or previous malignancy were included in the study. Subjects with refusal for questionnaire, contra-indication to radiation, history of prior radiation to brain, any second malignancy, severe co morbid conditions, patients participating in other trials or receiving any investigational drugs and patient not oriented to time, place and person were excluded from the study. Study Tools : Karnofsky performance status scoring criteria WHO Brain tumor classification 2016 Structured study instruments EORTC QLC30/ BN20 Brain site specific CT Simulator Treatment Planning System iy DICOM Network. Radiation Therapy oncology group (RTOG)contouring guidelines MRI brain (Siemen’s magnetomAvanto) 1.5 Tesla. Study Protocol All the patients who met the criteria for adjuvant Radiotherapy / chemoradiotherapy were included and treated after Tumor Board approval. All eligible patients were subjected to detailed history, examination and questionnaire fill ups. Pretreatment work-up consisted of complete medical history, physical examination, systemic examination including neurological examination and baseline cognitive assessment, Complete hemogram and renal function test, MRI brain, Biopsy proven primary neoplasm, Performance status was assessed using the KPS scale. The source of proforma is the European organization of research and treatment of quality of life. Statistical analysis The data was collected and entered in MS-Excel 2010. Various statistical analyses were performed using SPSS 22 version. Descriptive statistics was calculated for quantitative variables. Frequency along with percentages was calculated for all the categorical variables. Comparison of difference of means was seen by using independent t-test for two groups and one way ANOVA for more than two groups. Repeated Measures ANOVA was used for checking the difference between more than two related groups. If p 0.05, then hypothesis is said to be statistically insignificant. Results The study population consisted of males (66.7%) and females (33.3%) and male: female ratio was 2:1. In age distribution, the mean age was 41 years. The range was between 11 to 80 years. The majority of patients (26.7%) were in the 3rd decade of life. In performance status, as per KPS Scoring criteria, majority of patients (68.9%) were having performance status 90% (table 1). Table 1: Baseline characteristics among the study population Variables Number(N) Frequecy (%) Gender Male Female 30 15 66.7 33.3 Age 21-30 31-40 41-50 51-60 61-70 71-80 7 12 7 11 3 1 15.5 26.6 15.5 24.4 6.66 2.22 KARNOFSKY performance status 70% 80% 90% Grades of Brain tumor High grade Low grade 6 8 31 32 13 13.3 17.8 68.9 71.1 28.8 At the time of presentation, headache was the most common symptom seen in 27 patients (39.71%). The 2nd most common symptom seen was seizure in 15 patients (22.06%). More than one symptom was seen in 21 patients (46.6%). Laterality of brain tumor was almost equal, right sided were 23 (51%) whereas left sided were 22 (49%). Subsite analysis showed that majority of patients having brain tumor was in frontal lobe 15(33.3%) and followed by >1 lobe in 11 patients (24.4%).The patients underwent Total/near surgery in 20 (44.4%)patients. High grade glioma population was comparetively more (71.1%) than low grade glioma ,Glioblastoma Multiforme was the most common histology in 36% of all patients. Toxicity profile during treatment was anaemia, grade II toxicity observed in 1 patient (2.4%) only . grade I in 2 patients ( 4.4%) patients No patients experienced grade III, IV toxicity. None of the patient was having neutropenia. Thrombocytopenia was seen in 1 patient (2.4%) was grade I. In global QOL analysis, the scores were almost similar pre EBRT and 6 weeks post treatment follow up period, however they were found improved during 3 month follow up and scoring was statistically significant at 6 months follow up with p value of 0.00 (table 2). Table 2: Quality of life scores (EORTC QLQ30) Before Treatment 6 Weeks after treatment 3 Months follow up 6 Months follow up p-value Global health status / QoL Global health status/ QoL (revised)† 58.70 ± 18.54 59.07 ± 11.21 66.11 ± 16.89 73.70 ± 9.885 0.000 Functional scales Physical functioning (revised)† 71.85 ± 24.81 65.33 ± 21.44 80.29 ± 21.83 86.81 ± 12.26 0.000 Role functioning (revised)† 73.70 ± 33.23 75.55 ± 24.77 85.18 ± 24.67 86.66 ± 14.03 0.018 Emotional functioning 74.07 ± 24.04 74.81 ± 20.37 81.66 ± 17.90 87.22 ± 9.501 0.001 Cognitive functioning 78.88 ± 23.13 85.55 ± 16.12 83.33 ± 23.02 80.14 ± 7.945 0.002 Social functioning 75.55 ± 26.49 77.03 ± 21.10 83.3 ± 20.10 92.96 ± 11.50 0.037 Symptom scales / items Fatigue 30.61 ± 26.60 26.17 ± 24.74 20 ± 20.73 15.80 ± 20.71 0.012 Nausea and vomiting 11.85 ± 22.64 12.96 ± 16.62 10.37 ± 20.80 6.296 ± 12.45 0.304 Pain 25.18 ± 20.90 24.81 ± 23.19 19.62 ± 19.23 13.70 ± 16.39 0.008 Dyspnea 5.185 ± 15.82 7.407 ± 15.71 5.185 ± 18.74 5.042 ± 18.40 0.395 Insomnia 11.85 ± 19.01 18.51 ± 21.96 14.81 ± 25.18 8.148 ± 14.48 0.084 Appetite loss 24.44 ± 34.37 19.25 ± 27.96 15.55 ± 26.20 4.444 ± 11.45 0.001 Constipation 17.77 ± 27.15 17.03 ± 25.24 11.85 ± 21.50 5.925 ± 12.88 0.044 Diarrhea 6.666 ± 20.84 7.407 ± 17.24 8.148 ± 22.64 2.962 ± 9.593 0.476 Financial difficulties 30.37 ± 32.42 25.92 ± 26.48 18.51 ± 19.53 5.925 ± 12.88 0.000 ***Yellow Highlighted value are significant at 5% level of significance as p-value<0.05. Table 3: Quality of life scores Brain Specific (EORTC BN 20) Before Treatment 6 Weeks after treatment 3 Months follow up 6 Months follow up p-value BFU (future uncertainty) 34.81 ± 21.11 31.11 ± 12.48 26.66 ± 17.73 12.40 ± 10.60 0.000 BVD (visual disorder) 10.61 ± 17.56 8.884 ± 5.413 7.603 ± 12.34 7.442 ± 2.315 0.002 BMD (motor dysfunction) 24.19 ± 19.28 17.28 ± 12.20 18.02 ± 15.22 11.11 ± 8.541 0.002 BCD (communication deficit) 12.59 ± 17.18 12.83 ± 16.74 7.654 ± 11.80 6.172 ± 7.696 0.026 BHA (headaches) 38.51 ± 24.57 38.51 ± 15.82 24.44 ± 19.33 25.92 ± 15.71 0.001 BSE (seizures) 19.25 ± 26.10 14.81 ± 24.15 14.07 ± 19.44 6.666 ± 15.24 0.017 BDR (drowsiness) 22.22 ± 23.57 27.40 ± 27.78 13.33 ± 17.97 12.59 ± 17.82 0.004 BHL (hair loss) 15.55 ± 22.01 14.81 ± 19.53 11.11 ± 17.40 11.11 ± 15.89 0.294 BIS (itchy skin) 10.37 ± 22.27 14.07 ± 19.44 8.148 ± 17.63 11.11 ± 17.40 0.445 BWL (weakness of legs) 22.22 ± 24.61 20.74 ± 17.82 17.03 ± 20.86 17.77 ± 18.25 0.460 BBC (bladder control) 5.925 ± 20.46 0.740 ± 4.969 2.962 ± 9.593 0.740 ± 4.969 0.132 In the study population, high grade and low grade gliomas were analysed with BN20 QOL scores High grade glioma patients showed more symptoms of Motor dysfunction (p<0.019), communication deficit (p<0.006) and headache (p<0.01) than the other symptoms like seizures, drowsiness, hair loss, itchy skin, weakness of legs, bladder control, and visual disorder (table 4). Table 4: Comparisons between high-grade and low-grade gliomas with BN-20 domains (symptom scales) Low grades (n=14) High grades (n=31) p-value BFU (future uncertainty) 32.73 ± 18.90 35.75 ± 22.27 0.663 BVD (visual disorder) 17.46 ± 24.15 7.526 ± 12.95 0.166 BMD (motor dysfunction) 15.87 ± 12.10 27.95 ± 20.86 0.019 BCD (communication deficit) 3.967 ± 10.31 16.48 ± 18.34 0.006 BHA (headaches) 45.23 ± 30.96 35.48 ± 20.96 0.001 BSE (seizures) 28.57 ± 28.81 15.05 ± 24.09 0.297 BDR (drowsiness) 14.28 ± 21.53 25.80 ± 23.89 0.109 +BHL (hair loss) 19.04 ± 28.38 13.97 ± 18.80 0.131 BIS (itchy skin) 11.90 ± 21.11 9.677 ± 23.08 0.549 BWL (weakness of legs) 14.28 ± 17.11 25.80 ± 26.81 0.148 BBC (bladder control) 2.380 ± 8.907 7.527 ± 23.89 0.441 ***Yellow Highlighted value are significant at 5% level of significance as p-value<0.05. Table 6: Association between QLQ-C30 (functional scales) with variables Variable Mean/P-value PF RF EF CF SF Global QL Age ( 60 years) Mean 73.49/55.00 77.23/37.50 75.93/55.00 78.86/79.16 77.23/58.23 59.96/45.83 p-value 0.157 0.021 0.343 0.980 0.176 0.148 Sex (Male/Female) Mean 69.11/77.33 73.88/73.33 72.22/77.77 75.55/85.55 75/76.66 56.11/63.88 p-value 0.3 0.959 0.471 0.175 0.845 0.188 Location (infratentorial/supratentorial) Mean 73.33/71.70 87.5/72.35 85/73.00 87.5/78.04 87.5/74.39 49.99/59.55 p-value 0.902 0.391 0.347 0.442 0.351 0.331 Laterality (Left/Right) Mean 67.53/76.36 65.94/81.81 69.27/79.09 74.63/83.33 71.73/79.54 57.97/59.46 p-value 0.237 0.11 0.174 0.211 0.329 0.79 WHO (low grade/high grade) Mean 83.33/66.66 88.09/67.20 79.52/71.61 77.38/79.56 85.71/70.96 67.26/54.83 p-value 0.008 0.012 0.312 0.773 0.03 0.036 Surgery (Total or subtotal/Biopsy) Mean 71.82/71.90 78.49/63.09 76.77/68.09 80.10/76.19 76.34/73.80 61.28/52.97 p-value 0.992 0.233 0.369 0.605 0.806 0.257 Tumor Size ( 6 cm) Mean 73.33/68.57 73.65/73.80 76.77/68.09 81.18/73.80 80.10/65.47 61.28/52.97 p-value 0.557 0.989 0.267 0.328 0.086 0.166 Dose (Radical /Hypofractionated) Mean 74.62/60.74 80.56/46.29 78.51/56.29 81.01/70.37 78.24/64.81 60.88/49.99 p-value 0.135 0.004 0.087 0.221 0.177 0.116 Tumor Location (Midline/Not midline) Mean 83.33/67.67 84.72/69.70 82.22/71.11 83.33/77.27 87.50/71.21 67.36/55.55 p-value 0.060 0.183 0.173 0.444 0.068 0.058 KPS Score ( 80) Mean 57.77/77.08 45.83/84.37 58.33/79.58 70.73/81.25 61.11/81.25 48.61/62.49 p-value 0.021 0.000 0.047 0.187 0.024 0.027 MRI (Completresponse/Partial Response) Mean 74.44/70.90 69.44/75.25 66.76/76.76 75.00/80.30 68.05/78.28 55.54/59.84 p-value 0.678 0.631 0.217 0.503 0.257 0.498 Table 7: Association between QLQ-C30 (symptom scales) with variables Variable Mean/P-value F NV Pain Dyspnoea Insomnia AL Constipation Diarrhoea FD Age ( 60 years) Mean 28.73/50.00 11.38/16.67 24.39/33.33 5.69/0.00 13.00/0.00 22.76/41.67 15.44/41.67 7.32/0.00 29.26/41.67 p-value 0.128 0.661 0.420 0.499 0.000 0.299 0.373 0.509 0.472 Sex (Male/Female) Mean 32.59/26.66 16.11/3.333 25.55/24.44 6.666/2.222 12.22/11.11 28.88/15.55 24.44/4.444 10/0 31.11/28.88 p-value 0.488 0.021 0.869 0.38 0.856 0.228 0.003 0.037 0.831 Location (infratentorial/ supratentorial) Mean 27.77/30.89 12.5/11.78 37.50/23.98 0/5.691 16.66/11.38 16.66/25.20 16.66/17.88 0/7.317 16.66/31.70 p-value 0.826 0.953 0.492 0.499 0.661 0.641 0.933 0.509 0.382 Laterality (left/Right) Mean 37.68/23.23 16.66/6.818 28.26/21.96 7.246/3.030 14.49/9.090 30.43/18.18 26.08/9.090 11.59/1.515 39.13/21.21 p-value 0.068 0.147 0.399 0.378 0.347 0.236 0.033 0.104 0.063 WHO (low grade/high grade) Mean 26.98/32.25 1.190/16.66 21.42/26.88 4.761/5.376 7.142/13.97 16.66/27.95 9.523/21.50 0/9.677 19.04/35.48 p-value 0.544 0.003 0.424 0.906 0.206 0.313 0.089 0.037 0.117 Surgery (Total or subtoal/Biopsy) Mean 29.39/33.33 11.82/11.90 23.65/28.57 5.376/4.761 10.75/14.28 20.43/33.33 20.43/11.90 6.451/7.142 33.33/23.80 p-value 0.651 0.992 0.472 0.906 0.57 0.248 0.335 0.919 0.368 Tumor Size ( 6 cm) Mean 30.82/30.15 10.21/15.47 25.26/25.00 6.451/2.380 13.97/7.142 22.58/28.57 19.35/14.28 3.225/14.28 22.58/47.61 p-value 0.939 0.477 0.969 0.431 0.206 0.594 0.568 0.222 0.015 Dose (Radical /Hypofractionated) Mean 25.30/51.85 10.18/18.51 21.30/40.74 4.63/7.41 12.96/7.41 20.37/40.74 15.74/25.93 5.56/11.11 30.56/29.63 p-value 0.006 0.329 0.011 0.643 0.439 0.113 0.320 0.481 0.940 Tumor Location (Midline/Not midline) Mean 25.00/32.66 9.72/12.63 20.83/26.77 2.78/6.06 8.33/13.13 11.11/29.29 5.55/22.22 8.33/6.06 13.89/36.36 p-value 0.399 0.708 0.406 0.544 0.460 0.118 0.068 0.750 0.038 KPS Score ( 80) Mean 43.51/26.04 16.66/10.41 30.55/22.91 2.77/6.25 11.11/12.50 36.11/20.83 25.00/15.62 8.333/6.25 41.66/20.04 p-value 0.065 0.547 0.290 0.527 0.833 0.195 0.317 0.774 0.162 On MRI (Complete response/Partial Response) Mean 36.11/28.61 9.72/12.62 26.38/24.74 2.77/6.06 13.88/11.11 36.11/20.20 25.25/15.15 8.33/6.06 38.88/27.27 p-value 0.410 0.707 0.819 0.544 0.670 0.173 0.287 0.750 0.293 PF: physical functioning , RF Role functioning EF emotional functioning , CF Cognitive functioning , SF Social functioning F:Fatigue , NV :Nausea and vomiting , FD :Financial difficulty ,AP :Appetite loss Age of patients were divided into two groups , elderly >60 years or non elderly <60 years .A significant variation was found with functional scales of QLQ C30 such as role( p<0.04) and physical functioning (p<0.05) was improved in non elderly group. .No difference was found in case of emotional, cognitive, social functioning. Symptom of insomnia was statistically significant with p value (0.00) in elderly patients. With respect to sex, males compared to females had aggravated symptom score of nausea and vomiting, diarrhea and constipation with significant mean and P values. Patients with less than KPS score of < 80 showed poor functioning (p <0.02), role functioning (p<0.00), emotional functioning (p<0.04), social functioning (p<0.02), and worse global quality of life with significant p value of(< 0.02) scales and significant deteriorating symptom score such as fatigue with significant p value of 0.05 in brain tumor patients. Low grade gliomas comparatively to high grade gliomas showed better global quality of life (p<0.03) with better physical functioning (p<0.008), role functioning (p<0.012) and social functioning (p<0.03). Similarly for symptom scales, high grade gliomas showed more symptoms such as Nausea and vomiting (p<0.003), Diarrhoea (p<0.03). Patients treated with radical chemoradiation regimen showed significant correlation with better role functioning (p <0.004) and improved pain score (p <0.011) and fatigue (p6 cm and midline brain tumors patients (table 6, 7). Discussion The treatment of brain tumors has undergone a paradigm shift. Robust and mature data from various randomized studies and meta analysis have shown the treatment of choice for brain tumors is by surgery followed by definitive chemoradiotherapy. As far as quality of life is concerned, there are only a few clinical trials that have compared QOL in patients treated with chemoradiotherapy 13 . The aim of this study was to study and to assess the various factors associated with changes of HRQOL and impact of Quality of life in patients of brain tumor who underwent concurrent chemoradiation in brain tumors. Prior to the completion of the landmark trial, the previous standard management for glioblastoma was surgical resection or debulking surgery followed by post operative radiation therapy. The trial by Stupp et al compared adjuvant radiation therapy alone to radiation therapy combined with chemotherapeutic agent, and their data concluded that the median overall survival of patients improved and established a new standard of care 14 . The median age in our study was 41 years which is similar to the median age of presentation in our country. Male to female distribution was 2:1. Majority of patients 27 (60%) presented with complaints of most common Headache followed by 2nd most common symptom as seizure (33.3%), and more than 1 symptom was seen in 21 patients (46.6%). Our results coincides with the presenting symptoms of brain tumor available in literature 9 . The EORTC QLQ-C30 was chosen for this research because many studies have confirmed its validity and it is easily completed by patients. Addition of a site specific module, the EORTC QLQ-BN 20, for brain tumors yield more prognostic data and therefore also included in this study. Surgery alone is not a standard treatment in brain tumors, since literature showed a complete resection cannot be achieved in all cases 15 , 16 . Of note, postoperative chemoradiation treatment (CRT) has been shown to increase survival rates 17 . The QOL in patients is a concept based on the subjective feelings of the individuals involved. Our sample size was small, but results showed that the both chemo radiotherapy treatment was well tolerated. Our study found out statistically significant results in QOL for symptom scores including fatigue, pain, constipation, appetite loss and insomnia. Role functioning also showed significant outcome. Functional symptoms included emotional, physical functioning, role functioning, cognitive function showed improvement with significant P value. A higher score meant a higher standard of quality and conversely a lower score meant poor health status 18 , 19 . In the study done by Mahalakshmi et al, on assessment of QOL of chemoradiation and surgery in brain tumor patients, similar trend was seen in role functioning and cognitive functioning 20 . These patients needed adequate counselling and moral and family support during and after the treatment. In other functional scales like physical functioning P value was statistically significant. Toxicity profile was assessed in terms of acute toxicity. Majority of the patients tolerated chemo radiotherapy protocol well. This is highlighted by the fact that 45 patients completed radiotherapy treatment without any interruptions and however 9 (21.95%) patients required admission for supportive care in the form of decongestive therapy measures. Symptom Scales of BN 20 with motor dysfunction, communication deficit, headache, with significant p value was seen more in high grade gliomas comparatively to low grade gliomas. Symptoms scales like Future uncertainty, drowsiness, Communication difficulty and headache were common in high grade glioma. In addition to the poor emotional, physical and social functioning, global QOL, and symptoms like Fatigue, Pain, hair loss was prominent in High grade gliomas. The score was improved after chemotherapeutic intervention and was maintained for a substantial period until the time of further progression. Furthermore, patients also experience cognitive dysfunction, changes in personality, and behavior as stated in a study by Baker et al 21 to 70% of brain tumor patients experience psychological distress, having symptoms of depression and anxiety. Thus, there is constellation of tumor and treatment sequelae which can negatively impact health-related quality of life in brain tumor patients 22 . In global QOL analysis, it showed gradual improvement after treatment. This showed us that Global QOL increases subsequent to the treatment indicating that the treatment is well tolerated. This study gave opportunity to improve Health related quality of life score via intervention methods prior to six months post treatment. Conclusion Chemoradiotherapy as adjuvant treatment for brain tumor patients who have undergone resection with curative intent is a safe and well tolerated regimen both with respect to quality of life and acute toxicity. Quality of life in Functional and Symptom scale of patients undergoing treatment for brain tumor, deteriorated significantly after treatment and gradually improved with time, as assessed on further follow up at 3 months and 6 months of treatment. Limitation of our study were as follows : 1 ) Small number of study subjects 2) Short follow up time 3 ) All patients were not treated with IMRT Technique Despite Severe limitations, this study could highlight QOL in different grades of brain tumor patients. The study in future could provide more therapeutic strategies for QOL to both patients and physicians for true informed decisions about treatment options and improve overall survival of the patients. Declarations Human Ethics and Consent to Participate Human Ethics and Consent to Participate declarations: not applicable. Ethics Approval Approval Committee / IRB: Institutional Ethics Committee, Himalayan Institute of Medical Sciences (IEC-HIMS/SRHU), Swami Rama Himalayan University, Dehradun, India. Funding No external funding was received for this study. Author Contribution Pooja Kalra:Conceived and designed the study, collected and curated patient and quality-of-life data, performed the primary data analysis, interpreted the results, and drafted the original manuscript.Meenu Gupta:Contributed to study design, supervised clinical data collection, assisted in data interpretation, and provided critical revisions to the manuscript.Viney Kumar:Assisted with statistical analysis, contributed to interpretation of findings, and participated in manuscript review and editing.Vipul Nautiyal:Provided clinical oversight, supervised methodology and radiotherapy-related components, contributed to study interpretation, and critically reviewed and refined the manuscript. References Dasgupta A, Gupta T, Jalali R (2016) Indian data on central nervous tumors: A summary of published work. 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Child Adolesc Psychiatr Clin 8(4):879–903 Niv D, Kreitler S (2001) Pain and quality of life. Pain Pract 1(2):150–161 Liu R, Page M, Solheim K, Fox S, Chang SM (2009) Quality of life in adults with brain tumors: current knowledge and future directions. Neuro Oncol 11(3):330–339 Hurst JR, Agarwal G, van Boven JF, Daivadanam M, Gould GS, Huang EW et al (2020) Critical review of multimorbidity outcome measures suitable for low-income and middle-income country settings: perspectives from the Global Alliance for Chronic Diseases (GACD) researchers. BMJ Open 10(9):e037079 Erharter A, Giesinger J, Kemmler G, Schauer-Maurer G, Stockhammer G, Muigg A et al (2010) Implementation of computer-based quality-of-life monitoring in brain tumor outpatients in routine clinical practice. J Pain Symptom Manage 39(2):219–229 Taphoorn MJ, Sizoo EM, Bottomley A (2010) Review on quality of life issues in patients with primary brain tumors. Oncologist 15(6):618 Renovanz M, Hickmann AK, Coburger J, Kohlmann K, Janko M, Reuter AK et al (2018) Assessing psychological and supportive care needs in glioma patients–feasibility study on the use of the Supportive Care Needs Survey Short Form (SCNS-SF 34‐G) and the Supportive Care Needs Survey Screening Tool (SCNS‐ST 9) in clinical practice. Eur J Cancer Care 27(1):e12598 Dubbink HJ, Atmodimedjo PN, Kros JM, French PJ, Sanson M, Idbaih A et al (2015) Molecular classification of anaplastic oligodendroglioma using next-generation sequencing: a report of the prospective randomized EORTC Brain Tumor Group 26951 phase III trial. Neuro-oncol 18(3):388–400 Stupp R, Perry JR, Brandes AA, Wick W, van den Bent MJ (2013) Optimal management of elderly patients with glioblastoma. Cancer Treat Rev 39(4):350–357 Saito T, Tamura M, Chernov MF, Ikuta S, Muragaki Y, Maruyama T (2018) Neurophysiological monitoring and awake craniotomy for resection of intracranial gliomas. Intracranial Gliomas Part I-Surgery 30:117–158 Mutter N, Stupp R (2006) Temozolomide: a milestone in neuro-oncology and beyond? Expert Rev Anticancer Therapy 6(8):1187–1204 Osoba D, Brada M, Prados MD, Yung WA (2000) Effect of disease burden on health-related quality of life in patients with malignant gliomas. Neuro-oncol 2(4):221–228 Gilbert MR, Won M, Bottomley A, Mendoza TR, Coens C, Werner-Wasik M et al (2013) Net clinical benefit analysis of radiation therapy oncology group 0525: a phase III trial comparing conventional adjuvant temozolomide with dose-intensive temozolomide in patients with newly diagnosed glioblastoma. J Clin Oncol 31(32):4076 Iwamoto FM, Cooper AR, Reiner AS, Nayak L, Abrey LE (2009) Glioblastoma in the elderly: The Memorial Sloan-Kettering Cancer Center Experience (1997-2007). Cancer: Interdisciplinary Int J Am Cancer Soc 115(16):3758–3766 Mahalakshmi P, Vanisree AJ (2015) Quality of life measures in glioma patients with different grades: A preliminary study. Indian J Cancer 52(4):580 Baker PD, Bambrough J, Fox JR, Kyle SD (2015) Health-related quality of life and psychological functioning in patients with primary malignant brain tumors: A systematic review of clinical, demographic and mental health factors. Neuro-Oncology Pract 3:211–221 Barker CA, Chang M, Chou JF, Zhang Z, Beal K, Gutin PH, Iwamoto FM (2012) Radiotherapy and concomitant temozolomide may improve survival of elderly patients with glioblastoma. J Neurooncol 109(2):391–397 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8178133","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":552731145,"identity":"ad1f21a9-46f4-41ad-9a3b-4b0970c08fb5","order_by":0,"name":"pooja kalra","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"pooja","middleName":"","lastName":"kalra","suffix":""},{"id":552731146,"identity":"b9394e05-847a-4a1e-8e3c-233314adda85","order_by":1,"name":"MEENU 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13:13:34","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":124494,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8178133/v1/ad098dadea3f8cea96ede804.html"},{"id":97900491,"identity":"58ed218a-0126-48a4-9177-5fcb752bf013","added_by":"auto","created_at":"2025-12-10 15:45:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":906976,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8178133/v1/1b37da63-d06b-42b2-8ca3-2734b01ee20f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Analysis of Quality of life in Brain tumour patients pre and post radiotherapy ","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePrimary brain tumors comprises 2% of all malignancies in the adult patient population \u0026nbsp;are the 10th leading cause of death for men and women\u003csup\u003e1\u003c/sup\u003e. The most commonly occurring malignant brain tumour was glioblastoma . There were 81,246 deaths attributed to malignant brain and other CNS tumors between 2013 and 2018. This represents an average annual mortality rate of 4.42. The 5-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 23.5% and for benign and other CNS tumor was 82.4%\u003csup\u003e2\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAccording to the GLOBOCAN 2018 ,India overall estimated mortality in \u0026nbsp;was 24,003 cases\u003csup\u003e3\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003ePrimary brain tumors are subdivided into benign and malignant types and classified according to the World Health Organization (WHO) Classification, ranging from, WHO grade I meningioma to WHO grade IV glioblastoma. Symptoms vary according to the location of the tumor and include paralysis or sensory disturbances, increased intracranial pressure, personality changes, epileptic seizures, cognitive impairments, and visual disorder. All these symptoms may markedly affect health-related quality of life (HRQOL)\u003csup\u003e6\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003ePatients with primary brain tumors face serious challenges to their QOL\u003csup\u003e7\u003c/sup\u003e. They have difficulties with general symptoms such as headache, anorexia, nausea, seizures, and insomnia. These patients also face symptoms secondary to focal neurological deterioration, including motor deficits, personality changes, cognitive deficits, aphasia, or visual field defects\u003csup\u003e8\u003c/sup\u003e..\u003c/p\u003e\n\u003cp\u003eFor evaluation of QOL, the EORTC QLQ-C30 questionnaire and the QLQ-BN20 questionnaire are used. \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThere are limited clinical guidelines available regarding management of symptoms and factors affecting quality of life in brain tumors. We henceforth conducted an observational prospective follow up study to assess the factors associated with Quality Of life in brain tumor patients using EORTC QLQ-C30/BN20 questionnaire at baseline, six weeks, three months and six months.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThe prospective observational follow up study was conducted in the Department of Radiation Oncology, over a period of 12 months, among 45 consecutive cases presented over a period of one year with brain tumour. Subjects were recruited from OPD of Radiation Oncology with histopathologically proven diagnosis of brain tumor after taking written and informed consent.\u003c/p\u003e\u003cp\u003eAll patients\u0026thinsp;\u0026gt;\u0026thinsp;10 years of age belonging to either gender, histologically proven cases of brain tumor, life expectancy\u0026thinsp;\u0026gt;\u0026thinsp;3 months, KPS\u0026thinsp;\u0026gt;\u0026thinsp;70% and patients with no evidence of synchronous or previous malignancy were included in the study. Subjects with refusal for questionnaire, contra-indication to radiation, history of prior radiation to brain, any second malignancy, severe co morbid conditions, patients participating in other trials or receiving any investigational drugs and patient not oriented to time, place and person were excluded from the study.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy Tools\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eKarnofsky performance status scoring criteria\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eWHO Brain tumor classification 2016\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eStructured study instruments EORTC QLC30/ BN20 Brain site specific\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eCT Simulator\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eTreatment Planning System iy DICOM Network.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eRadiation Therapy oncology group (RTOG)contouring guidelines\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eMRI brain (Siemen\u0026rsquo;s magnetomAvanto) 1.5 Tesla.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy Protocol\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAll the patients who met the criteria for adjuvant Radiotherapy / chemoradiotherapy were included and treated after Tumor Board approval. All eligible patients were subjected to detailed history, examination and questionnaire fill ups.\u003c/p\u003e\u003cp\u003ePretreatment work-up consisted of complete medical history, physical examination, systemic examination including neurological examination and baseline cognitive assessment, Complete hemogram and renal function test, MRI brain, Biopsy proven primary neoplasm, Performance status was assessed using the KPS scale. The source of proforma is the European organization of research and treatment of quality of life.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003cp\u003eThe data was collected and entered in MS-Excel 2010. Various statistical analyses were performed using SPSS 22 version. Descriptive statistics was calculated for quantitative variables. Frequency along with percentages was calculated for all the categorical variables. Comparison of difference of means was seen by using independent t-test for two groups and one way ANOVA for more than two groups. Repeated Measures ANOVA was used for checking the difference between more than two related groups. If p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, then hypothesis is said to be statistically significant and if p\u0026thinsp;\u0026gt;\u0026thinsp;0.05, then hypothesis is said to be statistically insignificant.\u003c/p\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study population consisted of males (66.7%) and females (33.3%) and male: female ratio was 2:1. In age distribution, the mean age was 41 years. The range was between 11 to 80 years. The majority of patients (26.7%) were in the 3rd decade of life. In performance status, as per KPS Scoring criteria, majority of patients (68.9%) were having performance status 90% (table 1).\u003c/p\u003e\n\u003cp\u003eTable 1: Baseline characteristics among the study population\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eVariables\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eNumber(N)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eFrequecy (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eGender\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMale\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e66.7\u003c/p\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003cp\u003e21-30\u003c/p\u003e\n \u003cp\u003e31-40\u003c/p\u003e\n \u003cp\u003e41-50\u003c/p\u003e\n \u003cp\u003e51-60\u003c/p\u003e\n \u003cp\u003e61-70\u003c/p\u003e\n \u003cp\u003e71-80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e15.5\u003c/p\u003e\n \u003cp\u003e26.6\u003c/p\u003e\n \u003cp\u003e15.5\u003c/p\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003cp\u003e6.66\u003c/p\u003e\n \u003cp\u003e2.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eKARNOFSKY performance status\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e70%\u003c/p\u003e\n \u003cp\u003e80%\u003c/p\u003e\n \u003cp\u003e90%\u003c/p\u003e\n \u003cp\u003eGrades of Brain tumor\u003c/p\u003e\n \u003cp\u003eHigh grade\u003c/p\u003e\n \u003cp\u003eLow grade\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003cp\u003e17.8\u003c/p\u003e\n \u003cp\u003e68.9\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e71.1\u003c/p\u003e\n \u003cp\u003e28.8\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAt the time of presentation, headache was the most common symptom seen in 27 patients (39.71%). The 2nd most common symptom seen was seizure in 15 patients (22.06%). More than one symptom was seen in 21 patients (46.6%). Laterality of brain tumor was almost equal, right sided were 23 (51%) whereas left sided were 22 (49%). Subsite analysis showed that majority of patients having brain tumor was in frontal lobe 15(33.3%) and followed by \u0026gt;1 lobe in 11 patients (24.4%).The patients underwent Total/near surgery in 20 (44.4%)patients. High grade glioma population was comparetively more (71.1%) than low grade glioma ,Glioblastoma Multiforme was the most common histology in 36% of all patients.\u003c/p\u003e\n\u003cp\u003eToxicity profile during treatment was anaemia, grade II toxicity observed in 1 patient (2.4%) only . grade I \u0026nbsp;in 2 patients ( 4.4%) patients No patients experienced grade III, IV toxicity. None of the patient was having neutropenia. Thrombocytopenia was seen in 1 patient (2.4%) was grade I.\u003c/p\u003e\n\u003cp\u003eIn global QOL analysis, the scores were almost similar pre EBRT and 6 weeks post treatment follow up period, however they were found improved during 3 month follow up and scoring was statistically significant at 6 months follow up with p value of 0.00 (table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2:\u0026nbsp;\u003c/strong\u003eQuality of life scores (EORTC QLQ30)\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore Treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6 Weeks after treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3 Months follow up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6 Months follow up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGlobal health status / QoL\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eGlobal health status/ QoL (revised)\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e58.70 \u0026plusmn; 18.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e59.07 \u0026plusmn; 11.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e66.11 \u0026plusmn; 16.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e73.70 \u0026plusmn; 9.885\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFunctional scales\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003ePhysical functioning (revised)\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e71.85 \u0026plusmn; 24.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e65.33 \u0026plusmn; 21.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e80.29 \u0026plusmn; 21.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e86.81 \u0026plusmn; 12.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eRole functioning (revised)\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e73.70 \u0026plusmn; 33.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e75.55 \u0026plusmn; 24.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e85.18 \u0026plusmn; 24.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e86.66 \u0026plusmn; 14.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eEmotional functioning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e74.07 \u0026plusmn; 24.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e74.81 \u0026plusmn; 20.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e81.66 \u0026plusmn; 17.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e87.22 \u0026plusmn; 9.501\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eCognitive functioning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e78.88 \u0026plusmn; 23.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e85.55 \u0026plusmn; 16.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e83.33 \u0026plusmn; 23.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e80.14 \u0026plusmn; 7.945\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eSocial functioning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e75.55 \u0026plusmn; 26.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e77.03 \u0026plusmn; 21.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e83.3 \u0026plusmn; 20.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e92.96 \u0026plusmn; 11.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSymptom scales / items\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eFatigue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e30.61 \u0026plusmn; 26.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e26.17 \u0026plusmn; 24.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e20 \u0026plusmn; 20.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e15.80 \u0026plusmn; 20.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eNausea and vomiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e11.85 \u0026plusmn; 22.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e12.96 \u0026plusmn; 16.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e10.37 \u0026plusmn; 20.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e6.296 \u0026plusmn; 12.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.304\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003ePain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e25.18 \u0026plusmn; 20.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e24.81 \u0026plusmn; 23.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e19.62 \u0026plusmn; 19.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e13.70 \u0026plusmn; 16.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eDyspnea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e5.185 \u0026plusmn; 15.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e7.407 \u0026plusmn; 15.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e5.185 \u0026plusmn; 18.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e5.042 \u0026plusmn; 18.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.395\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eInsomnia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e11.85 \u0026plusmn; 19.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e18.51 \u0026plusmn; 21.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e14.81 \u0026plusmn; 25.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e8.148 \u0026plusmn; 14.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eAppetite loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e24.44 \u0026plusmn; 34.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e19.25 \u0026plusmn; 27.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e15.55 \u0026plusmn; 26.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e4.444 \u0026plusmn; 11.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eConstipation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e17.77 \u0026plusmn; 27.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e17.03 \u0026plusmn; 25.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e11.85 \u0026plusmn; 21.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e5.925 \u0026plusmn; 12.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eDiarrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e6.666 \u0026plusmn; 20.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e7.407 \u0026plusmn; 17.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e8.148 \u0026plusmn; 22.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e2.962 \u0026plusmn; 9.593\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.476\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21px;\"\u003e\n \u003cp\u003eFinancial difficulties\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e30.37 \u0026plusmn; 32.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19px;\"\u003e\n \u003cp\u003e25.92 \u0026plusmn; 26.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e18.51 \u0026plusmn; 19.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e5.925 \u0026plusmn; 12.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e***Yellow Highlighted value are significant at 5% level of significance as p-value\u0026lt;0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3:\u0026nbsp;\u003c/strong\u003eQuality of life scores Brain Specific (EORTC BN 20)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"619\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore Treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6 Weeks after treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3 Months follow up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6 Months follow up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBFU (future uncertainty)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e34.81 \u0026plusmn; 21.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e31.11 \u0026plusmn; 12.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e26.66 \u0026plusmn; 17.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e12.40 \u0026plusmn; 10.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBVD (visual disorder)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.61 \u0026plusmn; 17.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e8.884 \u0026plusmn; 5.413\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e7.603 \u0026plusmn; 12.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e7.442 \u0026plusmn; 2.315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBMD (motor dysfunction)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e24.19 \u0026plusmn; 19.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e17.28 \u0026plusmn; 12.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e18.02 \u0026plusmn; 15.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e11.11 \u0026plusmn; 8.541\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBCD (communication deficit)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e12.59 \u0026plusmn; 17.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e12.83 \u0026plusmn; 16.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e7.654 \u0026plusmn; 11.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e6.172 \u0026plusmn; 7.696\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBHA (headaches)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e38.51 \u0026plusmn; 24.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e38.51 \u0026plusmn; 15.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e24.44 \u0026plusmn; 19.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e25.92 \u0026plusmn; 15.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBSE (seizures)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e19.25 \u0026plusmn; 26.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e14.81 \u0026plusmn; 24.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e14.07 \u0026plusmn; 19.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e6.666 \u0026plusmn; 15.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBDR (drowsiness)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e22.22 \u0026plusmn; 23.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e27.40 \u0026plusmn; 27.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e13.33 \u0026plusmn; 17.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e12.59 \u0026plusmn; 17.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBHL (hair loss)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e15.55 \u0026plusmn; 22.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e14.81 \u0026plusmn; 19.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e11.11 \u0026plusmn; 17.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e11.11 \u0026plusmn; 15.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.294\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBIS (itchy skin)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.37 \u0026plusmn; 22.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e14.07 \u0026plusmn; 19.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e8.148 \u0026plusmn; 17.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e11.11 \u0026plusmn; 17.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.445\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBWL (weakness of legs)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e22.22 \u0026plusmn; 24.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e20.74 \u0026plusmn; 17.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e17.03 \u0026plusmn; 20.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e17.77 \u0026plusmn; 18.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.460\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBBC (bladder control)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e5.925 \u0026plusmn; 20.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 107px;\"\u003e\n \u003cp\u003e0.740 \u0026plusmn; 4.969\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 97px;\"\u003e\n \u003cp\u003e2.962 \u0026plusmn; 9.593\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e0.740 \u0026plusmn; 4.969\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.132\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;In the study population, high grade and low grade gliomas were analysed with BN20 QOL scores High grade glioma patients showed more symptoms of Motor dysfunction (p\u0026lt;0.019), communication deficit (p\u0026lt;0.006) and headache (p\u0026lt;0.01) than the other symptoms like seizures, drowsiness, hair loss, itchy skin, weakness of legs, bladder control, and visual disorder (table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4:\u0026nbsp;\u003c/strong\u003eComparisons between high-grade and low-grade gliomas with BN-20 domains (symptom scales)\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLow grades\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=14)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHigh grades\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=31)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003eBFU (future uncertainty)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e32.73 \u0026plusmn; 18.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e35.75 \u0026plusmn; 22.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.663\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003eBVD (visual disorder)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e17.46 \u0026plusmn; 24.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e7.526 \u0026plusmn; 12.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e0.166\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003eBMD (motor dysfunction)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e15.87 \u0026plusmn; 12.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e27.95 \u0026plusmn; 20.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003eBCD (communication deficit)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e3.967 \u0026plusmn; 10.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e16.48 \u0026plusmn; 18.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003eBHA (headaches)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e45.23 \u0026plusmn; 30.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e35.48 \u0026plusmn; 20.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003eBSE (seizures)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e28.57 \u0026plusmn; 28.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e15.05 \u0026plusmn; 24.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.297\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003eBDR (drowsiness)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e14.28 \u0026plusmn; 21.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e25.80 \u0026plusmn; 23.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003e+BHL (hair loss)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e19.04 \u0026plusmn; 28.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e13.97 \u0026plusmn; 18.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.131\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003eBIS (itchy skin)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e11.90 \u0026plusmn; 21.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e9.677 \u0026plusmn; 23.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.549\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003eBWL (weakness of legs)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e14.28 \u0026plusmn; 17.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e25.80 \u0026plusmn; 26.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 37px;\"\u003e\n \u003cp\u003eBBC (bladder control)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22px;\"\u003e\n \u003cp\u003e2.380 \u0026plusmn; 8.907\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23px;\"\u003e\n \u003cp\u003e7.527 \u0026plusmn; 23.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003e0.441\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e***Yellow Highlighted value are significant at 5% level of significance as p-value\u0026lt;0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6: Association between QLQ-C30 (functional scales) with variables\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"869\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean/P-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003ePF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eRF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eEF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eCF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eSF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eGlobal QL\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eAge (\u0026lt;60/\u003cu\u003e\u0026gt;\u003c/u\u003e60 years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e73.49/55.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e77.23/37.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e75.93/55.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e78.86/79.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e77.23/58.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e59.96/45.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.343\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.980\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eSex (Male/Female)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e69.11/77.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e73.88/73.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e72.22/77.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e75.55/85.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e75/76.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e56.11/63.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.959\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.471\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.175\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.845\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.188\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eLocation (infratentorial/supratentorial)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e73.33/71.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e87.5/72.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e85/73.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e87.5/78.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e87.5/74.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e49.99/59.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.902\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.391\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.442\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.331\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eLaterality (Left/Right)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e67.53/76.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e65.94/81.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e69.27/79.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e74.63/83.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e71.73/79.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e57.97/59.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eWHO (low grade/high grade)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e83.33/66.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e88.09/67.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e79.52/71.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e77.38/79.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e85.71/70.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e67.26/54.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.773\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eSurgery (Total or subtotal/Biopsy)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e71.82/71.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e78.49/63.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e76.77/68.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e80.10/76.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e76.34/73.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e61.28/52.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.992\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.369\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.605\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.806\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.257\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eTumor Size (\u0026lt;6/\u003cu\u003e\u0026gt;\u003c/u\u003e6 cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e73.33/68.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e73.65/73.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e76.77/68.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e81.18/73.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e80.10/65.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e61.28/52.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.557\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.989\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.328\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.166\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eDose\u003c/p\u003e\n \u003cp\u003e(Radical /Hypofractionated)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e74.62/60.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e80.56/46.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e78.51/56.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e81.01/70.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e78.24/64.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e60.88/49.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.177\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.116\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eTumor Location\u003c/p\u003e\n \u003cp\u003e(Midline/Not midline)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e83.33/67.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e84.72/69.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e82.22/71.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e83.33/77.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e87.50/71.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e67.36/55.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.060\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.183\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.444\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eKPS Score\u003c/p\u003e\n \u003cp\u003e(\u003cu\u003e\u0026lt;\u003c/u\u003e80/\u0026gt;80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e57.77/77.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e45.83/84.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e58.33/79.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e70.73/81.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e61.11/81.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e48.61/62.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003cp\u003e(Completresponse/Partial Response)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e74.44/70.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e69.44/75.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e66.76/76.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e75.00/80.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e68.05/78.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e55.54/59.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.678\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.631\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.503\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e0.498\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7: Association between QLQ-C30 (symptom scales) with variables\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"970\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean/P-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003eNV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003ePain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003eDyspnoea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003eInsomnia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003eAL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003eConstipation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003eDiarrhoea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003eFD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eAge (\u0026lt;60/\u003cu\u003e\u0026gt;\u003c/u\u003e60 years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e28.73/50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e11.38/16.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e24.39/33.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e5.69/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e13.00/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e22.76/41.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e15.44/41.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e7.32/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e29.26/41.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.661\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.420\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.499\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.299\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.373\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.509\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.472\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eSex (Male/Female)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e32.59/26.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e16.11/3.333\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e25.55/24.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e6.666/2.222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e12.22/11.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e28.88/15.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e24.44/4.444\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e10/0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e31.11/28.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.488\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.869\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.856\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.228\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.831\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eLocation (infratentorial/ supratentorial)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e27.77/30.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e12.5/11.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e37.50/23.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0/5.691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e16.66/11.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e16.66/25.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e16.66/17.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0/7.317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e16.66/31.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.826\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.953\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.492\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.499\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.661\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.641\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.933\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.509\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.382\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eLaterality (left/Right)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e37.68/23.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e16.66/6.818\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e28.26/21.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e7.246/3.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e14.49/9.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e30.43/18.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e26.08/9.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e11.59/1.515\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e39.13/21.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.378\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.033\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eWHO (low grade/high grade)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e26.98/32.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e1.190/16.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e21.42/26.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e4.761/5.376\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e7.142/13.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e16.66/27.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e9.523/21.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0/9.677\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e19.04/35.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.544\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.906\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.117\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eSurgery (Total or subtoal/Biopsy)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e29.39/33.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e11.82/11.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e23.65/28.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e5.376/4.761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e10.75/14.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e20.43/33.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e20.43/11.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e6.451/7.142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e33.33/23.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.651\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.992\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.472\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.906\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.248\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.335\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.919\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.368\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eTumor Size (\u0026lt;6/\u003cu\u003e\u0026gt;\u003c/u\u003e6 cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e30.82/30.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e10.21/15.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e25.26/25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e6.451/2.380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e13.97/7.142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e22.58/28.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e19.35/14.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e3.225/14.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e22.58/47.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.939\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.477\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.969\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.431\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.594\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.568\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eDose\u003c/p\u003e\n \u003cp\u003e(Radical /Hypofractionated)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e25.30/51.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e10.18/18.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e21.30/40.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e4.63/7.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e12.96/7.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e20.37/40.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e15.74/25.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e5.56/11.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e30.56/29.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.643\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.439\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.320\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.481\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.940\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eTumor Location\u003c/p\u003e\n \u003cp\u003e(Midline/Not midline)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e25.00/32.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e9.72/12.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e20.83/26.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.78/6.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e8.33/13.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e11.11/29.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e5.55/22.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e8.33/6.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e13.89/36.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.708\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.406\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.544\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.460\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.750\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.038\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eKPS Score\u003c/p\u003e\n \u003cp\u003e(\u003cu\u003e\u0026lt;\u003c/u\u003e80/\u0026gt;80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e43.51/26.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e16.66/10.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e30.55/22.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.77/6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e11.11/12.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e36.11/20.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e25.00/15.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e8.333/6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e41.66/20.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.065\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.547\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.290\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.527\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.833\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.774\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.162\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eOn MRI\u003c/p\u003e\n \u003cp\u003e(Complete response/Partial Response)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e36.11/28.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e9.72/12.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e26.38/24.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.77/6.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e13.88/11.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e36.11/20.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e25.25/15.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e8.33/6.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e38.88/27.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.410\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.707\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.819\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.544\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.670\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.750\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.293\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003ePF: physical functioning , RF Role functioning EF emotional functioning , CF Cognitive functioning , SF Social functioning F:Fatigue , NV :Nausea and vomiting , FD :Financial difficulty ,AP :Appetite loss\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAge of patients were divided into two groups , elderly \u0026gt;60 years or non elderly \u0026lt;60 years .A significant variation was found with functional scales of QLQ C30 such as role( p\u0026lt;0.04) and physical functioning (p\u0026lt;0.05) was improved in non elderly group. .No difference was found in case of emotional, cognitive, social functioning. Symptom of insomnia was statistically significant with p value (0.00) in elderly patients. With respect to sex, males compared to females had aggravated symptom score of nausea and vomiting, diarrhea and constipation with significant mean and P values. Patients with less than KPS score of \u0026lt; 80 showed poor functioning (p \u0026lt;0.02), role functioning (p\u0026lt;0.00), emotional functioning (p\u0026lt;0.04), social functioning (p\u0026lt;0.02), and worse global quality of life with significant p value of(\u0026lt; 0.02) scales and significant deteriorating symptom score such as fatigue with significant p value of 0.05 in brain tumor patients. Low grade gliomas comparatively to high grade gliomas showed better global quality of life (p\u0026lt;0.03) with better physical functioning (p\u0026lt;0.008), role functioning (p\u0026lt;0.012) and social functioning (p\u0026lt;0.03). Similarly for symptom scales, high grade gliomas showed more symptoms such as Nausea and vomiting (p\u0026lt;0.003), Diarrhoea (p\u0026lt;0.03). Patients treated with radical chemoradiation regimen showed significant correlation with better role functioning (p \u0026lt;0.004) and improved pain score (p \u0026lt;0.011) and fatigue (p\u0026lt; 0.006) compared to hypofractionated radiation therapy in brain tumor patients. Financial difficulties was seen more in tumor size \u0026gt;6 cm and midline brain tumors patients (table 6, 7).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe treatment of brain tumors has undergone a paradigm shift. Robust and mature data from various randomized studies and meta analysis have shown the treatment of choice for brain tumors is by surgery followed by definitive chemoradiotherapy. As far as quality of life is concerned, there are only a few clinical trials that have compared QOL in patients treated with chemoradiotherapy\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. The aim of this study was to study and to assess the various factors associated with changes of HRQOL and impact of Quality of life in patients of brain tumor who underwent concurrent chemoradiation in brain tumors.\u003c/p\u003e\u003cp\u003ePrior to the completion of the landmark trial, the previous standard management for glioblastoma was surgical resection or debulking surgery followed by post operative radiation therapy. The trial by Stupp et al compared adjuvant radiation therapy alone to radiation therapy combined with chemotherapeutic agent, and their data concluded that the median overall survival of patients improved and established a new standard of care \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe median age in our study was 41 years which is similar to the median age of presentation in our country. Male to female distribution was 2:1. Majority of patients 27 (60%) presented with complaints of most common Headache followed by 2nd most common symptom as seizure (33.3%), and more than 1 symptom was seen in 21 patients (46.6%). Our results coincides with the presenting symptoms of brain tumor available in literature\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe EORTC QLQ-C30 was chosen for this research because many studies have confirmed its validity and it is easily completed by patients. Addition of a site specific module, the EORTC QLQ-BN 20, for brain tumors yield more prognostic data and therefore also included in this study. Surgery alone is not a standard treatment in brain tumors, since literature showed a complete resection cannot be achieved in all cases \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Of note, postoperative chemoradiation treatment (CRT) has been shown to increase survival rates \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe QOL in patients is a concept based on the subjective feelings of the individuals involved. Our sample size was small, but results showed that the both chemo radiotherapy treatment was well tolerated. Our study found out statistically significant results in QOL for symptom scores including fatigue, pain, constipation, appetite loss and insomnia. Role functioning also showed significant outcome.\u003c/p\u003e\u003cp\u003eFunctional symptoms included emotional, physical functioning, role functioning, cognitive function showed improvement with significant P value. A higher score meant a higher standard of quality and conversely a lower score meant poor health status\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. In the study done by Mahalakshmi et al, on assessment of QOL of chemoradiation and surgery in brain tumor patients, similar trend was seen in role functioning and cognitive functioning \u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThese patients needed adequate counselling and moral and family support during and after the treatment. In other functional scales like physical functioning P value was statistically significant.\u003c/p\u003e\u003cp\u003eToxicity profile was assessed in terms of acute toxicity. Majority of the patients tolerated chemo radiotherapy protocol well. This is highlighted by the fact that 45 patients completed radiotherapy treatment without any interruptions and however 9 (21.95%) patients required admission for supportive care in the form of decongestive therapy measures.\u003c/p\u003e\u003cp\u003eSymptom Scales of BN 20 with motor dysfunction, communication deficit, headache, with significant p value was seen more in high grade gliomas comparatively to low grade gliomas. Symptoms scales like Future uncertainty, drowsiness, Communication difficulty and headache were common in high grade glioma. In addition to the poor emotional, physical and social functioning, global QOL, and symptoms like Fatigue, Pain, hair loss was prominent in High grade gliomas. The score was improved after chemotherapeutic intervention and was maintained for a substantial period until the time of further progression.\u003c/p\u003e\u003cp\u003eFurthermore, patients also experience cognitive dysfunction, changes in personality, and behavior as stated in a study by Baker et al\u003csup\u003e21\u003c/sup\u003e to 70% of brain tumor patients experience psychological distress, having symptoms of depression and anxiety. Thus, there is constellation of tumor and treatment sequelae which can negatively impact health-related quality of life in brain tumor patients\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn global QOL analysis, it showed gradual improvement after treatment. This showed us that Global QOL increases subsequent to the treatment indicating that the treatment is well tolerated. This study gave opportunity to improve Health related quality of life score via intervention methods prior to six months post treatment.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eChemoradiotherapy as adjuvant treatment for brain tumor patients who have undergone resection with curative intent is a safe and well tolerated regimen both with respect to quality of life and acute toxicity. Quality of life in Functional and Symptom scale of patients undergoing treatment for brain tumor, deteriorated significantly after treatment and gradually improved with time, as assessed on further follow up at 3 months and 6 months of treatment.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eLimitation of our study were as follows\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e1 ) Small number of study subjects\u003c/p\u003e\u003cp\u003e2) Short follow up time\u003c/p\u003e\u003cp\u003e3 ) All patients were not treated with IMRT Technique\u003c/p\u003e\u003cp\u003eDespite Severe limitations, this study could highlight QOL in different grades of brain tumor patients. The study in future could provide more therapeutic strategies for QOL to both patients and physicians for true informed decisions about treatment options and improve overall survival of the patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eHuman Ethics and Consent to Participate\u003c/h2\u003e\n\u003cp\u003eHuman Ethics and Consent to Participate declarations: not applicable.\u003c/p\u003e\n\u003ch2\u003eEthics Approval\u003c/h2\u003e\n\u003cp\u003eApproval Committee / IRB: Institutional Ethics Committee, Himalayan Institute of Medical Sciences (IEC-HIMS/SRHU), Swami Rama Himalayan University, Dehradun, India.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eNo external funding was received for this study.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003ePooja Kalra:Conceived and designed the study, collected and curated patient and quality-of-life data, performed the primary data analysis, interpreted the results, and drafted the original manuscript.Meenu Gupta:Contributed to study design, supervised clinical data collection, assisted in data interpretation, and provided critical revisions to the manuscript.Viney Kumar:Assisted with statistical analysis, contributed to interpretation of findings, and participated in manuscript review and editing.Vipul Nautiyal:Provided clinical oversight, supervised methodology and radiotherapy-related components, contributed to study interpretation, and critically reviewed and refined the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDasgupta A, Gupta T, Jalali R (2016) Indian data on central nervous tumors: A summary of published work. South Asian J Cancer 5(3):147\u0026ndash;153\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOstrom QT, Patil N, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS (2020) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2013\u0026ndash;2017. Neurooncol 22(Supplement1):iv1\u0026ndash;96\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFerlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Pi\u0026ntilde;eros M et al (2019) Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 144(8):1941\u0026ndash;1953\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKushi LH, Byers T, Doyle C, Bandera EV, McCullough M, Gansler T et al (2006) American Cancer Society Guidelines on Nutrition and Physical Activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA: Cancer J Clin 56(5):254\u0026ndash;281\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTesta U, Castelli G, Pelosi E (2018) Genetic abnormalities, clonal evolution, and cancer stem cells of brain tumors. Med Sci 6(4):85\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSiffert J, Greenleaf M, Mannis R, Allen J (1999) Pediatric brain tumors. Child Adolesc Psychiatr Clin 8(4):879\u0026ndash;903\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNiv D, Kreitler S (2001) Pain and quality of life. Pain Pract 1(2):150\u0026ndash;161\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLiu R, Page M, Solheim K, Fox S, Chang SM (2009) Quality of life in adults with brain tumors: current knowledge and future directions. Neuro Oncol 11(3):330\u0026ndash;339\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHurst JR, Agarwal G, van Boven JF, Daivadanam M, Gould GS, Huang EW et al (2020) Critical review of multimorbidity outcome measures suitable for low-income and middle-income country settings: perspectives from the Global Alliance for Chronic Diseases (GACD) researchers. BMJ Open 10(9):e037079\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eErharter A, Giesinger J, Kemmler G, Schauer-Maurer G, Stockhammer G, Muigg A et al (2010) Implementation of computer-based quality-of-life monitoring in brain tumor outpatients in routine clinical practice. J Pain Symptom Manage 39(2):219\u0026ndash;229\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTaphoorn MJ, Sizoo EM, Bottomley A (2010) Review on quality of life issues in patients with primary brain tumors. Oncologist 15(6):618\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRenovanz M, Hickmann AK, Coburger J, Kohlmann K, Janko M, Reuter AK et al (2018) Assessing psychological and supportive care needs in glioma patients\u0026ndash;feasibility study on the use of the Supportive Care Needs Survey Short Form (SCNS-SF 34‐G) and the Supportive Care Needs Survey Screening Tool (SCNS‐ST 9) in clinical practice. Eur J Cancer Care 27(1):e12598\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDubbink HJ, Atmodimedjo PN, Kros JM, French PJ, Sanson M, Idbaih A et al (2015) Molecular classification of anaplastic oligodendroglioma using next-generation sequencing: a report of the prospective randomized EORTC Brain Tumor Group 26951 phase III trial. Neuro-oncol 18(3):388\u0026ndash;400\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eStupp R, Perry JR, Brandes AA, Wick W, van den Bent MJ (2013) Optimal management of elderly patients with glioblastoma. Cancer Treat Rev 39(4):350\u0026ndash;357\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSaito T, Tamura M, Chernov MF, Ikuta S, Muragaki Y, Maruyama T (2018) Neurophysiological monitoring and awake craniotomy for resection of intracranial gliomas. Intracranial Gliomas Part I-Surgery 30:117\u0026ndash;158\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMutter N, Stupp R (2006) Temozolomide: a milestone in neuro-oncology and beyond? Expert Rev Anticancer Therapy 6(8):1187\u0026ndash;1204\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOsoba D, Brada M, Prados MD, Yung WA (2000) Effect of disease burden on health-related quality of life in patients with malignant gliomas. Neuro-oncol 2(4):221\u0026ndash;228\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGilbert MR, Won M, Bottomley A, Mendoza TR, Coens C, Werner-Wasik M et al (2013) Net clinical benefit analysis of radiation therapy oncology group 0525: a phase III trial comparing conventional adjuvant temozolomide with dose-intensive temozolomide in patients with newly diagnosed glioblastoma. J Clin Oncol 31(32):4076\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIwamoto FM, Cooper AR, Reiner AS, Nayak L, Abrey LE (2009) Glioblastoma in the elderly: The Memorial Sloan-Kettering Cancer Center Experience (1997-2007). Cancer: Interdisciplinary Int J Am Cancer Soc 115(16):3758\u0026ndash;3766\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMahalakshmi P, Vanisree AJ (2015) Quality of life measures in glioma patients with different grades: A preliminary study. Indian J Cancer 52(4):580\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBaker PD, Bambrough J, Fox JR, Kyle SD (2015) Health-related quality of life and psychological functioning in patients with primary malignant brain tumors: A systematic review of clinical, demographic and mental health factors. Neuro-Oncology Pract 3:211\u0026ndash;221\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBarker CA, Chang M, Chou JF, Zhang Z, Beal K, Gutin PH, Iwamoto FM (2012) Radiotherapy and concomitant temozolomide may improve survival of elderly patients with glioblastoma. J Neurooncol 109(2):391\u0026ndash;397\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Brain Tumour, CT, MRI, Quality of life, Radiotherapy","lastPublishedDoi":"10.21203/rs.3.rs-8178133/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8178133/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eThe study of quality of life in patients with brain tumours during and after radiation therapy can aid in the development of effective interventional therapies for a variety of symptoms.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim\u003c/strong\u003e: An observational prospective follow-up study using the EORTC QLQ-C30/BN20 questionnaire to investigate the parameters related with quality of life in brain tumour patients at baseline, six weeks, three months, and six months after radiotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and methods: \u003c/strong\u003eThe prospective observational follow-up study was conducted over a period of 12 months in the Department of Radiation Oncology at Himalayan Institute of Medical Sciences (HIMS), Swami Rama Himalayan University, Jollygrant, Dehradun, among 45 consecutive cases of brain tumour presented over a one-year period. Complete medical history, physical examination, systemic examination (including neurological examination and baseline cognitive assessment), complete hemogram and renal function test, MRI brain, Biopsy proven primary neoplasm, Performance status was assessed using the KPS scale, and the source of proforma was the European organisation for research and treatment of quality of life and mini mental status examination.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults and conclusion:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBoth high grade and low had poor mean scores in cognitive functioning , emotional functioning . High grade glioma showed more symptoms of motor dysfunction (p\u0026lt;0.019), communication deficit (p\u0026lt;0.006) .The mean scores of physical functioning , role functioning , and social functioning were better in low grade gliomas. With respect to QLQ C-30/BN 20 domains , High grade glioma patients showed more symptom score such as headache (p\u0026lt;0.01) , Nausea and vomiting (p\u0026lt;0.003). Karnofsky performance status showed significant associations with all the functional scales. The patients treated with radical chemoradiation therapy showed significant correlation with role functioning (p\u0026lt;0.004) and improved pain score and fatigue compared to hypofractionated radiation therapy in brain tumor patients.\u003c/p\u003e\n\u003cp\u003eQuality of life in Functional and Symptom scale scoring, in patients undergoing treatment for brain tumor, deteriorated significantly after treatment and gradually improved with time, as assessed on further follow up at 3 months and 6 months .\u003c/p\u003e","manuscriptTitle":"Analysis of Quality of life in Brain tumour patients pre and post radiotherapy ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-01 10:57:14","doi":"10.21203/rs.3.rs-8178133/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"df410473-3964-4424-8e5b-e114e91ed272","owner":[],"postedDate":"December 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-10T11:39:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-01 10:57:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8178133","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8178133","identity":"rs-8178133","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}
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