Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA.
Neuro Oncol. 2011 Apr;13(4):428-36. doi: 10.1093/neuonc/nor005. Epub 2011 Mar 1.
Elderly patients have largely been excluded from randomized trials for glioblastoma multiforme (GBM). We reviewed the results of treatment approaches, which included surgery, chemotherapy, and radiation in this group of patients. Patients were treated during the period 1979-2007 and were 70 years of age and older with histologically confirmed GBM. Overall survival (OS) was the primary endpoint of this retrospective study. Two hundred six patients 70 years of age and older were identified. Median age was 75 years (range 70-90). Median OS time was 4.5 months. Univariate analysis showed that OS was significantly impacted by KPS score (1.8 months for KPS ≤ 50 to 17.2 months for KPS ≥ 90, P < .001), age at diagnosis (5.1 months for age 70-79 versus 3.1 months for age ≥ 80, P < .001), and extent of disease (worse for bilateral disease [P = .003], multifocal disease [P = .005], and multicentric disease [P = .02]). On multivariate analysis, higher KPS score (P = .006), surgical resection (any surgery beyond biopsy) (P < .001), radiation therapy (P < .001), and chemotherapy (P < .001) were all found to be independently associated with improved OS. In this study of newly diagnosed glioblastoma patients over the age of 70 years, aggressive treatment with radiation, chemotherapy, and surgery is associated with OS.
老年患者在胶质母细胞瘤（GBM）的随机试验中大多被排除在外。我们回顾了这组患者的治疗方法，包括手术、化疗和放疗。这些患者在 1979 年至 2007 年期间接受治疗，年龄为 70 岁及以上，经组织学证实为 GBM。本回顾性研究的主要终点是总生存期（OS）。共确定了 206 名年龄在 70 岁及以上的患者。中位年龄为 75 岁（范围为 70-90 岁）。中位 OS 时间为 4.5 个月。单因素分析显示，OS 受 KPS 评分显著影响（KPS≤50 为 1.8 个月，KPS≥90 为 17.2 个月，P<.001），诊断时年龄（70-79 岁为 5.1 个月，≥80 岁为 3.1 个月，P<.001）和疾病程度（双侧疾病更差[P=.003]，多发病灶[P=.005]，多中心疾病[P=.02]）。多因素分析显示，较高的 KPS 评分（P=.006）、手术切除（活检以外的任何手术）（P<.001）、放疗（P<.001）和化疗（P<.001）均与 OS 改善独立相关。在这项新诊断的年龄超过 70 岁的胶质母细胞瘤患者的研究中，积极的放疗、化疗和手术治疗与 OS 相关。
