Kushnir Igal, Tzuk-Shina Tzahala
Oncology Insitute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Isr Med Assoc J. 2011 May;13(5):290-4.
Glioblastoma multiforme (GBM) is an ultimately fatal disease that affects patients of all ages. Elderly patients (65 years and older) constitute a special subgroup of patients characterized by a worse prognosis and frequent comorbidities.
To assess the efficacy of different treatment modalities in terms of survival in elderly patients with GBM.
Using retrospective analysis, we extracted, anonymized and analyzed the files of 74 deceased patients (aged 65 or older) treated for GBM in a single institution.
Mean survival time was 8.97 months and median survival time 7.68 months. Patients who underwent tumor resection had a mean survival of 11.83 months, as compared to patients who underwent no surgical intervention or only biopsy and had a mean survival of 5.22 months (P < 0.0001). Patients who underwent full radiation treatment had amean survival of 11.31 months, compared to patients who received only partial radiotherapy or none at all and had a mean survival of 4.09 months (P < 0.0001). Patients who underwent chemotherapy had a mean survival of 12.4 months, compared to patients who did not receive any chemotherapy andhad a mean survival of 5.89 months (P < 0.001).
Age alone should not be a factor in the decision on which treatment should be given. Treatment should be individualized to match the patient's overall condition and his or her wishes, while taking into consideration the better overall prognosis expected with aggressive treatment.
多形性胶质母细胞瘤(GBM)是一种最终会致命的疾病,影响各个年龄段的患者。老年患者(65岁及以上)构成了一个特殊的患者亚组,其特点是预后较差且常伴有合并症。
评估不同治疗方式对老年GBM患者生存情况的疗效。
通过回顾性分析,我们提取、匿名化并分析了在单一机构接受GBM治疗的74例已故患者(年龄65岁及以上)的病历。
平均生存时间为8.97个月,中位生存时间为7.68个月。接受肿瘤切除术的患者平均生存时间为11.83个月,而未接受手术干预或仅接受活检的患者平均生存时间为5.22个月(P<0.0001)。接受全量放射治疗的患者平均生存时间为11.31个月,相比之下,仅接受部分放疗或未接受任何放疗的患者平均生存时间为4.09个月(P<0.0001)。接受化疗的患者平均生存时间为12.4个月,未接受任何化疗的患者平均生存时间为5.89个月(P<0.001)。
年龄本身不应成为决定给予何种治疗的因素。治疗应个体化,以匹配患者的整体状况和意愿,同时考虑到积极治疗有望带来更好的总体预后。