Glantz Michael, Chamberlain Marc, Liu Qin, Litofsky N Scott, Recht Lawrence D
Southwestern Vermont Cancer Center, Bennington, Vermont, USA.
Cancer. 2003 May 1;97(9):2262-6. doi: 10.1002/cncr.11323.
The optimal treatment for elderly patients (defined as patients 70 years of age or older) with malignant gliomas (MG) remains controversial. Some physicians advocate withholding therapy following diagnosis based on the observation that elderly patients do not tolerate adjuvant radiotherapy. The availability of temozolomide (TMZ), a new alkylating agent with antiglioma efficacy, offers another potential therapeutic option for these patients. The drug can be administered orally at home with minimal morbidity.
The authors retrospectively reviewed a cohort of 86 consecutive elderly MG patients from three institutions, 32 of whom received monthly TMZ in lieu of radiation.
Initial Karnofsky performance score was the only predictor of survival in this cohort. No difference in survival was noted between these two groups. Toxicity was minimal in the chemotherapy-treated group and a higher percentage of patients receiving chemotherapy died at home.
The authors concluded that TMZ is as effective as irradiation as a treatment of elderly patients with MG. It is an alternative and, perhaps, a superior therapeutic option to irradiation, based on its ease of administration and low morbidity.
老年恶性胶质瘤（MG）患者（定义为70岁及以上患者）的最佳治疗方案仍存在争议。一些医生主张在诊断后不进行治疗，理由是观察到老年患者无法耐受辅助放疗。替莫唑胺（TMZ）是一种具有抗胶质瘤疗效的新型烷化剂，为这些患者提供了另一种潜在的治疗选择。该药物可在家口服，发病率极低。
作者回顾性分析了来自三个机构的86例连续老年MG患者，其中32例接受每月一次的TMZ治疗而非放疗。
初始卡诺夫斯基表现评分是该队列中生存的唯一预测因素。两组在生存率上没有差异。化疗治疗组的毒性极小，接受化疗的患者在家中死亡的比例更高。
作者得出结论，TMZ作为老年MG患者的治疗方法与放疗一样有效。基于其易于给药和低发病率，它是放疗的一种替代方案，甚至可能是更好的治疗选择。
