Neurology Department, CHU Hautepierre, rue Molière, Strasbourg 67000, France.
Cancers (Basel). 2013 Sep 24;5(3):1177-98. doi: 10.3390/cancers5031177.
This study aimed to analyze the treatment and outcomes of older glioblastoma patients. Forty-four patients older than 70 years of age were referred to the Paul Strauss Center for chemotherapy and radiotherapy. The median age was 75.5 years old (range: 70-84), and the patients included 18 females and 26 males. The median Karnofsky index (KI) was 70%. The Charlson indices varied from 4 to 6. All of the patients underwent surgery. O6-methylguanine-DNA methyltransferase (MGMT) methylation status was determined in 25 patients. All of the patients received radiation therapy. Thirty-eight patients adhered to a hypofractionated radiation therapy schedule and six patients to a normofractionated schedule. Neoadjuvant, concomitant and adjuvant chemotherapy regimens were administered to 12, 35 and 20 patients, respectively. At the time of this analysis, 41 patients had died. The median time to relapse was 6.7 months. Twenty-nine patients relapsed, and 10 patients received chemotherapy upon relapse. The median overall survival (OS) was 7.2 months and the one- and two-year OS rates were 32% and 12%, respectively. In a multivariate analysis, only the Karnofsky index was a prognostic factor. Hypofractionated radiotherapy and chemotherapy with temozolomide are feasible and acceptably tolerated in older patients. However, relevant prognostic factors are needed to optimize treatment proposals.
本研究旨在分析老年胶质母细胞瘤患者的治疗和结局。44 名年龄大于 70 岁的患者被转诊至 Paul Strauss 中心接受化疗和放疗。中位年龄为 75.5 岁(范围:70-84),患者包括 18 名女性和 26 名男性。中位卡氏功能状态评分(Karnofsky index,KI)为 70%。Charlson 指数从 4 到 6 不等。所有患者均接受手术治疗。25 名患者检测了 O6-甲基鸟嘌呤-DNA 甲基转移酶(O6-methylguanine-DNA methyltransferase,MGMT)甲基化状态。所有患者均接受放射治疗。38 名患者接受了低分割放疗方案,6 名患者接受了常规分割放疗方案。12、35 和 20 名患者分别接受了新辅助、同步和辅助化疗方案。在本分析时,41 名患者已经死亡。中位复发时间为 6.7 个月。29 名患者复发,10 名患者复发后接受了化疗。中位总生存期(overall survival,OS)为 7.2 个月,1 年和 2 年 OS 率分别为 32%和 12%。在多变量分析中,只有卡氏功能状态评分是预后因素。对于老年患者,替莫唑胺的低分割放疗和化疗是可行且可耐受的。然而,需要相关的预后因素来优化治疗方案。