Treatment outcomes in glioblastoma patients aged 76?years or older: a multicenter retrospective cohort study

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• 作者：Takeo Uzuka (1)
  Kenichiro Asano (2)
  Toshio Sasajima (3)
  Kaori Sakurada (4)
  Toshihiro Kumabe (5)
  Takaaki Beppu (6)
  Masahiro Ichikawa (7)
  Chifumi Kitanaka (8)
  Hiroshi Aoki (9)
  Kiyoshi Saito (7)
  Kuniaki Ogasawara (6)
  Teiji Tominaga (5)
  Kazuo Mizoi (3)
  Hiroki Ohkuma (2)
  Yukihiko Fujii (9)
  Takamasa Kayama (4)
  
• 关键词：Glioblastoma ; Karnofsky performance status score ; Elderly patients ; Temozolomide
• 刊名：Journal of Neuro-Oncology
• 出版年：2014
• 出版时间：January 2014
• 年：2014
• 卷：116
• 期：2
• 页码：299-306
• 全文大小：205 KB
• 作者单位：Takeo Uzuka (1)
  Kenichiro Asano (2)
  Toshio Sasajima (3)
  Kaori Sakurada (4)
  Toshihiro Kumabe (5)
  Takaaki Beppu (6)
  Masahiro Ichikawa (7)
  Chifumi Kitanaka (8)
  Hiroshi Aoki (9)
  Kiyoshi Saito (7)
  Kuniaki Ogasawara (6)
  Teiji Tominaga (5)
  Kazuo Mizoi (3)
  Hiroki Ohkuma (2)
  Yukihiko Fujii (9)
  Takamasa Kayama (4)
  
  1. Department of Neurosurgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-chou, Chuo-ku, Niigata, 951-8566, Japan
  2. Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
  3. Department of Neurosurgery, Akita University Graduate School of Medicine, Akita, Japan
  4. Department of Neurosurgery, Yamagata University School of Medicine, Yamagata, Japan
  5. Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
  6. Department of Neurosurgery, Iwate Medical University, Morioka, Japan
  7. Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan
  8. Department of Molecular Cancer Science, Yamagata University School of Medicine, Yamagata, Japan
  9. Department of Neurosurgery, Brain Research Institute, University of Niigata, Niigata, Japan
  
• ISSN：1573-7373

文摘

Age is one of the most important prognostic factors in glioblastoma patients, but no standard treatment has been established for elderly patients with this condition. We therefore conducted a retrospective cohort study to evaluate treatment regimens and outcomes in elderly glioblastoma patients. The study population consisted of 79 glioblastoma patients aged ?6?years (median age 78.0?years; 34 men and 45 women). The median preoperative Karnofsky performance status (KPS) score was 60. Surgical procedures were classified as biopsy (31 patients, 39.2?%), <95?% resection of the tumor (21 patients, 26.9?%), and ?5?% resection of the tumor (26 patients, 33.3?%). Sixty-seven patients (81.0?%) received radiotherapy and 45 patients (57.0?%) received chemotherapy. The median overall progression-free survival time was 6.8?months, and the median overall survival time was 9.8?months. Patients aged ?8?years were significantly less likely to receive radiotherapy (p?=?0.004). Patients with a postoperative KPS score of ?0 were significantly more likely to receive maintenance chemotherapy (p?=?0.008). Multivariate analyses identified two independent prognostic factors: postoperative KPS score ?0 (hazard ratio [HR]?=?0.531, 95?% confidence interval [CI] 0.315-.894, p?=?0.017) and temozolomide therapy (HR?=?0.442, 95?% CI 0.25-.784, p?<?0.001).The findings of this study suggest that postoperative KPS score is an important prognostic factor for glioblastoma patients aged ?6?years, and that these patients may benefit from temozolomide therapy.