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首页> 外文期刊>British journal of neurosurgery >Prognostic factors and survival study in high-grade glioma in the elderly
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Prognostic factors and survival study in high-grade glioma in the elderly

机译：老年人高级别神经胶质瘤的预后因素和生存研究

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Background Glioblastoma multiforme (GBM) is the most common and malignant primary brain tumour in adults. Due to the ageing of the population, diagnosis in the elderly is becoming more common. The aim of this study was to analyse different combinations of treatments and to identify preoperative factors, including O6-methylguanine-DNA methyltransferase status, that may be associated with decreased survival among patients older than 70 years. Methods and materials We retrospectively included all patients over 70 years of age, who underwent surgery at the Department of Neurosurgery (HUCA and HUMV) and were diagnosed of GBM by pathological criteria from January 2007 to September 2014. Results Eighty-one patients were analysed, whose mean age was 75 (SD 4) and 48 were male. Karnofsky performance status (KPS) was over 70 in 61 patients and 38.3% presented with motor deficit. Sixty-three patients underwent resection, and 18 had only a diagnostic biopsy. The complication rate was 17.28% and mortality rate was 7.4%. Survival was increased in patients who received radiotherapy (n = 41) or additional chemotherapy (n = 26) (p<0.001). KPS570 was an independent factor associated with low-rate survival. Patients with optimal treatment had a median survival of 8 months compared to patients with suboptimal treatment who had a median survival of 4 months (p<0.001). Conclusions This study suggests that KPS is the most important preoperative prognostic factor. Maximal safe resection followed by radical radiotherapy and temozolomide might be the optimal treatment of choice since glioblastoma-diagnosed patients over 70 years of age showed a statistically significant survival benefit.
机译：背景多形胶质母细胞瘤（GBM）是成人中最常见，最恶性的原发性脑肿瘤。由于人口老龄化，老年人的诊断越来越普遍。这项研究的目的是分析不同的治疗组合，并确定术前因素，包括O6-甲基鸟嘌呤-DNA甲基转移酶的状况，这些因素可能与70岁以上患者的存活率下降有关。方法和材料我们回顾性分析了2007年1月至2014年9月在神经外科（HUCA和HUMV）接受手术治疗并通过病理学标准诊断为GBM的所有70岁以上的患者。结果分析了81例患者，平均年龄为75岁（SD 4），男性为48岁。 Karnofsky表现状态（KPS）在61例患者中超过70，其中38.3％表现为运动障碍。进行了切除的患者为63例，只有18例诊断性活检。并发症发生率为17.28％，死亡率为7.4％。接受放射治疗（n = 41）或接受其他化疗（n = 26）的患者的生存率增加了（p <0.001）。 KPS570是与低率生存相关的独立因素。与接受次优治疗的患者中位生存期为4个月的患者相比，接受最佳治疗的患者中位生存期为8个月（p <0.001）。结论这项研究表明KPS是最重要的术前预后因素。选择最大的安全切除术，然后行根治性放疗和替莫唑胺治疗可能是最佳选择，因为诊断为胶质母细胞瘤的70岁以上患者具有统计学意义的生存获益。

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