Supportive Care in Brain Tumors and Quality of Life

Despite current multimodality treatment, including surgery, radiotherapy and chemotherapy, and ongoing development of potentially more effective novel therapeutic modalities, the prognosis of patients with Primary malignant brain tumors still remains poor. Palliative and supportive care are very important for effective management of neurological symptoms and complications directly or indirectly caused by the intracranial lesion. In this chapter, determinants of quality of life and the management of most frequent and/or relevant symptoms, such as seizures, edema, venous thromboembolism, fatigue, mood and behavioral disorders, cognition, work ability, dysphagia, headache, death rattle, alterations of consciousness, and delirium will be discussed together with problems associated with nutrition, hydration, and respiration. To better understand how to approach glioma patients, the organization of care in the end of life phase and how to recognize and reduce the influence of treatment on Health-Related Quality of Life (HRQOL) will be also debated. The effect of supportive treatments on HRQOL will be reported together with the advantages associated with the use of patient-reported outcome measures in neuro-oncology.