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Purpose <p>Alternating electric fields (AEF) therapy has been shown to improve the overall survival of patients with WHO grade 4 astrocytoma. Few have explored its impact on health-related quality-of-life (HRQoL) and caregiver stress.</p> Methods <p>This was a prospective, multi-centre, registry-based study of adult patients with WHO grade 4 astrocytoma who received either AEF plus temozolomide chemoradiotherapy (AEF + CRT) or CRT alone, with EORTC QLQ-C30/BN20, CSI, and HK-MoCA assessments at baseline and every three months. The primary outcome was the global QLQ-30 score at 3 months after CRT. Secondary outcomes included the QLQ-30 functional score, symptom scores and the caregiver stress index (CSI) at 3 months.</p> Results <p>88 patients, 48 AEF + CRT and 40 CRT-alone, were reviewed. The mean AEF duration was 10 ± 8 months. At 3 months, AEF + CRT patients had significantly lower global QLQ-C30 scores than CRT-alone patients (44 ± 22 vs. 66 ± 20; between-group difference 22 points; <i>p</i> &lt; 0.001), exceeding the established minimally important difference of 4–6 points for glioma. On multivariable analysis, AEF therapy (adjusted OR 0.09, 95% CI 0.006–0.7) and preoperative KPS ≥ 80 (adjusted OR 0.09, 95% CI 0.01–0.5) were associated with lower odds of high global QoL (≥ 60). Functional and symptom scores were comparable between groups, apart from higher scalp pruritus in AEF + CRT patients. Mean caregiver CSI scores remained &lt; 7 at all time points.</p> Conclusion <p>In this prospective real-world cohort of Chinese patients with WHO grade 4 astrocytoma, AEF therapy was independently associated with a reduction in global HRQoL at 3 months compared with CRT alone, while functional and symptom domains and caregiver stress remained largely stable. These data should inform shared decision-making when weighing the survival benefit of AEF against its short-term QoL burden, especially in subtropical climates where scalp-related adverse effects may be more pronounced.</p>

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Health-related quality-of-life of WHO grade 4 astrocytoma patients receiving alternating electrical field therapy: a prospective real-world multi-centre study

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  • 发表日期：

    2026年5月21日

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  • Desiree K. K. Wong,
  • Jenny K. S. Pu,
  • Lai-Fung Li,
  • Victor K. H. Hui,
  • Kevin K. F. Suen,
  • Arthur C. K. Lau,
  • Danny T. M. Chan,
  • Michael W. Y. Lee,
  • Tony K. T. Chan,
  • Jason M. K. Ho,
  • Ka-Man Cheung,
  • Teresa P. K. Tse,
  • Sarah S. N. Lau,
  • Joyce S. W. Chow,
  • Michael K. W. See,
  • Natalie M. W. Ko,
  • Herbert H. F. Loong,
  • Dennis K. C. Leung,
  • Aya El-Helali,
  • Tai-Chung Lam,
  • Fung-Ching Cheung,
  • Wai-Sang Poon,
  • Peter Y. M. Woo

摘要

Purpose

Alternating electric fields (AEF) therapy has been shown to improve the overall survival of patients with WHO grade 4 astrocytoma. Few have explored its impact on health-related quality-of-life (HRQoL) and caregiver stress.

Methods

This was a prospective, multi-centre, registry-based study of adult patients with WHO grade 4 astrocytoma who received either AEF plus temozolomide chemoradiotherapy (AEF + CRT) or CRT alone, with EORTC QLQ-C30/BN20, CSI, and HK-MoCA assessments at baseline and every three months. The primary outcome was the global QLQ-30 score at 3 months after CRT. Secondary outcomes included the QLQ-30 functional score, symptom scores and the caregiver stress index (CSI) at 3 months.

Results

88 patients, 48 AEF + CRT and 40 CRT-alone, were reviewed. The mean AEF duration was 10 ± 8 months. At 3 months, AEF + CRT patients had significantly lower global QLQ-C30 scores than CRT-alone patients (44 ± 22 vs. 66 ± 20; between-group difference 22 points; p < 0.001), exceeding the established minimally important difference of 4–6 points for glioma. On multivariable analysis, AEF therapy (adjusted OR 0.09, 95% CI 0.006–0.7) and preoperative KPS ≥ 80 (adjusted OR 0.09, 95% CI 0.01–0.5) were associated with lower odds of high global QoL (≥ 60). Functional and symptom scores were comparable between groups, apart from higher scalp pruritus in AEF + CRT patients. Mean caregiver CSI scores remained < 7 at all time points.

Conclusion

In this prospective real-world cohort of Chinese patients with WHO grade 4 astrocytoma, AEF therapy was independently associated with a reduction in global HRQoL at 3 months compared with CRT alone, while functional and symptom domains and caregiver stress remained largely stable. These data should inform shared decision-making when weighing the survival benefit of AEF against its short-term QoL burden, especially in subtropical climates where scalp-related adverse effects may be more pronounced.