Internet-based guided self-help for glioma patients with depressive symptoms: a randomized controlled trial

On behalf of the Dutch Society for Neuro-Oncology (LWNO)

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Depressive symptoms are common in glioma patients, and can negatively affect health-related quality of life (HRQOL). We performed a nation-wide randomized controlled trial to evaluate the effects of an online guided self-help intervention for depressive symptoms in adult glioma patients. Glioma patients with depressive symptoms were randomized to a 5-week online course based on problem-solving therapy, or a waiting list control group. After having received the intervention, the glioma patient groups combined were compared with patients with cancer outside the central nervous system (non-CNS cancer controls), who also received the intervention. Sample size calculations yielded 63 participants to be recruited per arm. The primary outcome [depressive symptoms (CES-D)] and secondary outcomes [fatigue (Checklist Individual Strength (CIS)) and HRQOL (Short Form-36)], were assessed online at baseline, post-intervention, and 3 and 12 months follow-up. In total, 89 glioma patients (intervention N = 45; waiting list N = 44) and 26 non-CNS cancer controls were included, of whom 35 and 54% completed the intervention, respectively. Recruitment could not be extended beyond 3.5 years due to funding. On depression, no statistically significant differences between the groups were found. Fatigue decreased post-treatment in the glioma intervention group compared with the waiting list group (p = 0.054, d = 0.306). At 12 months, the physical component summary (HRQOL) remained stable in glioma patients, while scores improved in non-CNS cancer controls (p = 0.035, d = 0.883). In this underpowered study, no evidence for the effectiveness of online guided self-help for depression or HRQOL in glioma patients was found, but it may improve fatigue. Trial registration Netherlands Trial Register NTR3223.

Original languageEnglish
Pages (from-to)191-203
Number of pages13
JournalJournal of Neuro-Oncology
Issue number1
Publication statusPublished - Mar 2018


Funding This study is supported by a grant from the Dutch Cancer Society, Alpe d’HuZes (VU 2010–4808). The first author was furthermore supported by a Niels Stensen Fellowship and a Yorkshire Cancer Research University Academic Fellowship.

FundersFunder number
Alpe d’HuZesVU 2010–4808
Dutch Cancer Society
Yorkshire Cancer Research University
Yorkshire Cancer Research
Yorkshire Cancer ResearchL389FB
KWF Kankerbestrijding


    • Depression
    • Fatigue
    • Glioma
    • Neuro-oncology
    • Online therapy


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