Tumor-treating fields (TTFields) plus temozolomide improve survival outcomes without negatively affecting health-related quality of life (HRQoL) among patients with newly diagnosed glioblastoma, according to a study published in JAMA Oncology.1

Glioblastoma is considered an incurable disease, making prolonged survival and preservation of HRQoL the primary goals of therapy. A previous study demonstrated that TTFields — an antimitotic physical treatment modality — improves progression-free survival (PFS) and overall survival among patients with glioblastoma, but its influence on HRQoL was not evaluable at time of first analysis.

For the prospective phase 3 EF-14 study (ClinicalTrials.gov Identifier: NCT00916409), investigators randomly assigned 695 patients with newly diagnosed glioblastoma who were progression-free after standard radiotherapy and debulking surgery to receive continuous TTFields plus temozolomide vs temozolomide alone. HRQoL was assessed at baseline and every 3 months thereafter for a year using the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-C30) and brain module (QLQ-BN20).

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Patient adherence to questionnaire completion dropped from 91.9% (639) at baseline to 65.8% (431) at 3 months and to 41.7% (197) at 12 months of follow-up.

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HRQoL did not differ significantly between patients in the 2 treatment arms, except for an increased incidence of itchy skin for patients treated with TTFields (P < .001). Patients in the TTFields arm also had significantly improved global health status (P = .001), physical functioning (P = .001), pain (P < .001), and weakness of legs (P = .001). These findings may have been associated with the observed improved PFS.

The authors concluded that “the addition of this novel device-delivered treatment neither negatively affects nor improves functioning and well-being of the patient, including critical HRQoL issues, such as role, social, and physical functioning…Considering the net clinical benefit, our HRQoL data support the addition of TTFields to standard therapy in patients with glioblastoma.”


  1. Taphoorn MJ, Dirven L, Kanner AA, et al. Influence of treatment with tumor-treating fields on health-related quality of life of patients with newly diagnosed glioblastoma. JAMA Oncol. 2018 Feb 1. doi: 10.1001/jamaoncol.2017.5082 [Epub ahead of print]