Related Experiment Video
Updated: Jun 10, 2026
Establishment of Orthotopic Patient-derived Xenograft Models for Brain Tumors using a Stereotaxic Device
Published on: May 2, 2025
Measuring performance status in pediatric patients with brain tumors--experience of the HIT-GBM-C protocol
Johannes E A Wolff1, Kamran Mohiuddin, Norbert Jorch
1Division of Pediatrics, Section of Pediatric Neuro-oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. jwolff@mdanderson.org
Insights
The Fertigkeitenskala Münster-Heidelberg (FMH) scale effectively assesses pediatric neuro-oncology patients. Poor initial FMH scores correlate with worse outcomes in high-grade glioma and diffuse intrinsic pontine glioma.
Area of Science:
- Pediatric Oncology
- Quality of Life Assessment
- Neuro-Oncology
Background:
- Assessing quality of life in pediatric neuro-oncology presents significant challenges.
- This study reports on a treatment protocol for pediatric patients diagnosed with high-grade glioma and diffuse intrinsic pontine glioma.
Purpose of the Study:
- To evaluate the utility of the Fertigkeitenskala Münster-Heidelberg (FMH) scale in measuring health status for pediatric neuro-oncology patients.
- To determine the prognostic value of FMH scores at diagnosis and during treatment.
Main Methods:
- The Fertigkeitenskala Münster-Heidelberg (FMH), a 56-item quantitative health status measure, was administered to pediatric patients.
- Physicians provided independent assessments of patient health status on a 1-5 scale.
- Data were collected from 50 of 97 eligible patients, with 22 having both FMH and physician scores.
Main Results:
- A significant correlation was observed between FMH scores and physician judgments (P < 0.005).
- Patients with initial FMH scores below 40% had a markedly higher mortality rate (15 out of 16) compared to those scoring above 40% (4 out of 5 survived).
- Physician-assessed 'normal' activity decreased from 22% at diagnosis to 16% mid-treatment, while severely reduced activity increased from 16% to 30.6%.
Conclusions:
- The FMH scale offers a valid and easily administered method for assessing health status in pediatric neuro-oncology.
- Poorer performance status at diagnosis, as indicated by FMH scores, is associated with a worse prognosis for these patients.
Background:
Measuring the quality of life or performance status in pediatric neurooncology has proven a challenge. Here, we report in a treatment protocol for pediatric patients with high-grade glioma and diffuse intrinsic pontine glioma.
Procedure:
The Fertigkeitenskala Münster-Heidelberg (FMH) is a 56-item quantitative measure of health status. The number of yes answers is transformed to age-dependent percentiles. Physicians were also asked the patients' health status by their own judgment on a 1-5 scale: normal, mild handicap, age-normal activity severely reduced but patient not in bed, in bed, and in ICU.
Results:
Assessments were available from 50 of 97 eligible patients. For 22 patients both questionnaire and the physicians score obtained. At the beginning of the treatment, only 5 patients scored over 40 FMH%, and 4 of these survived. Of 16 patients who initially scored less than 40 FMH%, 15 died. During later assessments, most FMH measures became gradually worse. FMH scores improved in three patients. The physician's judgment was documented at diagnosis and during treatment (n = 50). Per physician, 22% of the patients were normal before chemotherapy, decreasing to 16% in the middle of the protocol. At diagnosis only 16% of patients had severely reduced activity, which increased to 30.6% in the middle of the protocol. The FMH% correlated well with the physicians' judgments (P < 0.005).
Conclusion:
The FMH scale is easily obtained and provides a valid assessment of health status. Patients with poor performance at diagnosis had a poorer prognosis.
