QLIF-13. EVALUATION OF ANXIETY SYMPTOMS AMONG BRAIN TUMOR PATIENTS; ARE WE PROVIDING APPROPRIATE, EFFECTIVE CARE?

BACKGROUND: Management of brain tumor patients can be complicated as anxiety may blur the lines of an existing complex symptomatology. Failure to evaluate or treat anxiety may increase the symptom burden compromising the cancer treatment picture and quality of life; but studies examining the occurrence and impact in brain tumor patients are limited. METHOD(S): Patients in the Neuro-Oncology Branch Natural History Study completed the GAD-7 (7-item self-report assessing anxiety symptoms rated from 0=not at all to 3=nearly every day) at enrollment. Scores were classified according to recognized cut-offs for a significant anxiety disorder (>=10) or warranting further assessment (>=5). The association of demographic and clinical variables with anxiety were evaluated using independent t-tests and chi-square tests. RESULT(S): 124 patients participated and were primarily white(85%), male(61%), with a median age of 48 and a diagnosis of Glioblastoma(31%). The average score was 4.1(SD=4.4, median=3.0)with a range of 0-20. Significant differences in GAD-7 scores were found in patients with previous tumor recurrence scoring 1.8 points higher than patients with no recurrence(p=0.042, n=123). Thirty eight percent of patients had at least modest anxiety(score >=5) while 11% had high anxiety (score >=10). Patients receiving psychotropic medications (57%) were more likely to report high anxiety than those not on psychotropic medications(8%)(p=0.003). The most common psychotropic medication was an SSRI, and 42% used 2-3 agents in combination. CONCLUSION(S): Anxiety was common among patients with malignant brain tumors, particularly with tumor recurrence. Severe anxiety was seen in the majority of patients on psychotropic medications, suggesting that treatment was often ineffective. Given that untreated or elevated anxiety can impair the patient's quality of life and therefore possibly compromising or altering treatment decisions, more investigation is needed to better assess, counsel and develop better therapies for this patient population.