Kim Miri, Ladomersky Erik, Mozny Andreas, Kocherginsky Masha, O'Shea Kaitlyn, Reinstein Zachary Z, Zhai Lijie, Bell April, Lauing Kristen L, Bollu Lakshmi, Rabin Erik, Dixit Karan, Kumthekar Priya, Platanias Leonidas C, Hou Lifang, Zheng Yinan, Wu Jennifer, Zhang Bin, Hrachova Maya, Merrill Sarah A, Mrugala Maciej M, Prabhu Vikram C, Horbinski Craig, James Charles David, Yamini Bakhtiar, Ostrom Quinn T, Johnson Margaret O, Reardon David A, Lukas Rimas V, Wainwright Derek A
Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois, USA.
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Neurooncol Adv. 2021 Sep 4;3(1):vdab125. doi: 10.1093/noajnl/vdab125. eCollection 2021 Jan-Dec.
Advanced age is a major risk factor for the development of many diseases including those affecting the central nervous system. Wild-type isocitrate dehydrogenase glioblastoma (IDH GBM) is the most common primary malignant brain cancer and accounts for ≥90% of all adult GBM diagnoses. Patients with IDH GBM have a median age of diagnosis at 68-70 years of age, and increasing age is associated with an increasingly worse prognosis for patients with this type of GBM.
The Surveillance, Epidemiology, and End Results, The Cancer Genome Atlas, and the Chinese Glioma Genome Atlas databases were analyzed for mortality indices. Meta-analysis of 80 clinical trials was evaluated for log hazard ratio for aging to tumor survivorship.
Despite significant advances in the understanding of intratumoral genetic alterations, molecular characteristics of tumor microenvironments, and relationships between tumor molecular characteristics and the use of targeted therapeutics, life expectancy for older adults with GBM has yet to improve.
Based upon the results of our analysis, we propose that age-dependent factors that are yet to be fully elucidated, contribute to IDH GBM patient outcomes.
高龄是包括影响中枢神经系统疾病在内的多种疾病发生发展的主要危险因素。野生型异柠檬酸脱氢酶胶质母细胞瘤(IDH GBM)是最常见的原发性恶性脑癌,占所有成人GBM诊断病例的≥90%。IDH GBM患者的诊断中位年龄为68 - 70岁,且年龄越大,这类GBM患者的预后越差。
分析监测、流行病学与最终结果数据库、癌症基因组图谱数据库以及中国胶质瘤基因组图谱数据库的死亡率指标。对80项临床试验进行荟萃分析,评估衰老对肿瘤生存率的对数风险比。
尽管在肿瘤内基因改变、肿瘤微环境分子特征以及肿瘤分子特征与靶向治疗应用之间的关系等方面的认识取得了重大进展,但老年GBM患者的预期寿命仍未改善。
基于我们的分析结果,我们提出尚未完全阐明的年龄依赖性因素会影响IDH GBM患者的预后。