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[老年胶质瘤患者生存预后因素分析]

[Analysis of prognostic factors for survival in 
elderly patients with glioma].

作者信息

Liu Jinghui, Lou Miao, Ji Peigang, Li Chen, Feng Fuqiang, Li Baofu, Xu Meng, Gao Guodong, Qu Yan, Wang Liang

机构信息

Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China.

Department of Neurosurgery, Second Hospital of Shanxi Medical University, Taiyuan 030001, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2018 Apr 28;43(4):403-409. doi: 10.11817/j.issn.1672-7347.2018.04.011.

Abstract

To analyze the prognostic factors for survival in elderly patients with glioma.
 Methods: We performed a retrospective analysis of prognostic factors for elderly patients with glioma, who were treated by the same attending doctor during June 2014 and June 2016, to investigate the correlations of the age, dimension of pathology, histological grade, extent of resection, adjuvant therapy, preoperative Karnofsky Performance Scale (KPS) score, postoperative KPS score, molecular markers [isocitrate dehydrogenase-1 (IDH-1), O6-methylguanine DNA-transferase (MGMT), epidermal growth factor receptor (EGFR), Ki-67] with the prognosis.
 Results: A total of 45 patients were included in the study. The median overall survival (OS) was 11 months. The median progression-free survival (PFS) was 6 months. Univariate analysis revealed that the age, gender, dimension of pathology, histological grade and preoperative KPS score had no significant correlation with survival (P>0.05). The gross total resection, higher postoperative KPS score, adjuvant therapy, lower Ki-67 index were significantly correlated with survival. The expressions of MGMT and EGFR were significant factors for survival. High postoperative KPS score (P=0.019), adjuvant therapy (P=0.024), and the expression of MGMT (P=0.026) were independent predictors for increased median OS in a multivariate regression model.
 Conclusion: The extent of resection, adjuvant therapy, postoperative KPS score and molecular markers are the influential factors for survival. Larger prospective studies are needed to confirm these findings.

摘要

分析老年胶质瘤患者生存的预后因素。

方法

我们对2014年6月至2016年6月期间由同一位主治医生治疗的老年胶质瘤患者的预后因素进行了回顾性分析,以研究年龄、病理尺寸、组织学分级、切除范围、辅助治疗、术前卡氏评分(KPS)、术后KPS评分、分子标志物[异柠檬酸脱氢酶-1(IDH-1)、O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)、表皮生长因子受体(EGFR)、Ki-67]与预后的相关性。

结果

本研究共纳入45例患者。中位总生存期(OS)为11个月。中位无进展生存期(PFS)为6个月。单因素分析显示,年龄、性别、病理尺寸、组织学分级和术前KPS评分与生存无显著相关性(P>0.05)。肿瘤全切除、术后KPS评分较高、辅助治疗、较低的Ki-得分与生存显著相关。MGMT和EGFR的表达是生存的重要因素。在多因素回归模型中,术后KPS评分高(P=0.019)、辅助治疗(P=0.024)和MGMT表达(P=0.026)是中位OS增加的独立预测因素。

结论

切除范围、辅助治疗、术后KPS评分和分子标志物是影响生存的因素。需要更大规模的前瞻性研究来证实这些发现。

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