Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
In Vivo. 2021 Jan-Feb;35(1):483-487. doi: 10.21873/invivo.12282.
BACKGROUND/AIM: Care is often palliative when patients are not fit and complete resection of glioblastomas cannot be achieved. This study aimed to identify predictors of survival after palliative radiotherapy.
Thirty-one patients irradiated after biopsy or incomplete resection of primary glioblastoma were retrospectively analyzed. Median total dose, dose per fraction and equivalent dose in 2 Gy fractions (EQD2) were 45.0 Gy, 3.0 Gy and 46.0 Gy, respectively. Median number of fractions was 15, median treatment time 3 weeks. Ten patients received temozolomide. Six factors were evaluated for survival including location of glioblastoma, Karnofsky performance score (KPS), gender, age, EQD2 and temozolomide.
KPS ≥60 showed a trend for improved survival (p=0.141). For other factors including EQD2, no significant association with survival was found.
Patients with a KPS ≤50 have a poor survival prognosis and appear good candidates for short-course radiotherapy. Selected patients with better KPS may be considered for more aggressive treatments.
背景/目的：当患者身体状况不佳且无法完全切除胶质母细胞瘤时，通常采取姑息治疗。本研究旨在确定姑息性放疗后生存的预测因素。
回顾性分析了 31 名经活检或不完全切除原发性胶质母细胞瘤后接受放疗的患者。中位总剂量、单次剂量和等效剂量 2Gy 分数（EQD2）分别为 45.0Gy、3.0Gy 和 46.0Gy。中位分割次数为 15 次，中位治疗时间为 3 周。10 名患者接受了替莫唑胺治疗。评估了 6 个因素与生存的关系，包括胶质母细胞瘤的位置、卡氏功能状态评分（KPS）、性别、年龄、EQD2 和替莫唑胺。
KPS≥60 显示出生存改善的趋势（p=0.141）。对于包括 EQD2 在内的其他因素，与生存无显著相关性。
KPS≤50 的患者生存预后较差，似乎是短程放疗的良好候选者。对于 KPS 较好的选定患者，可考虑更积极的治疗。
