短程放疗联合替莫唑胺在老年胶质母细胞瘤患者中的生存获益分析

目的 探讨短程放疗联合替莫唑胺(TMZ)方案在术后KPS评分较差的老年胶质母细胞瘤(GBM)患者治疗中的生存获益情况.方法 回顾分析行完整切除但术后KPS评分不佳的新诊断老年GBM患者71例,对不同MGMT状态下各辅助治疗方案进行生存分析和比较.结果 71例患者年龄65~85岁,平均(71.10±5.19)岁,其中男50例,年龄(71.36±5.35)岁,女21例,年龄(70.48±4.90)岁;其中62例在随访截止日期前死亡,总体平均生存期(OS)(11.92±0.51)个月,2年生存率0;接受短程同步放化疗联合TMZ辅助治疗组平均生存期显著提高(P=0.002),与单纯短程放疗组相比差异性最大(P=0.001),而单纯短程放疗与单纯TMZ辅助治疗组之间OS差异无统计学意义(P>0.05);术后免疫组化MGMT阴性表达组患者更能从短程同步放化疗联合TMZ辅助化疗中获得生存获益(P=0.004).结论 对于≥65岁接受肿瘤切除后功能状态不佳的老年GBM患者,短程同步放化疗联合TMZ辅助治疗可能是一种能获得更多生存获益的术后辅助治疗方案,在MGMT启动子甲基化患者中,这种获益优势更加明显.

An prognostic analysis of hypofractionated radiation plus Temozolomide for newly diagnosed glioblastoma in eld-erlies

Objective To investigate if a short -course concurrent chemoradiotherapy that yields a better mean survival in elderly patients with newly diagnosed glioblastoma multiforme (GBM) and poor post -operation performance. Methods This study included 71 newly diagnosed primary GBM patients aged 65 years or older with poor post -opera-tion KPS.Kaplan-Meier method stratified by MGMT status was used to compared the survival in different groups .Re-sults The mean age was (71.10 ±5.19) years old, among whom the mean age of 50 males was (71.36 ±5.35)years, and of 21 females was (70.48 ±4.90) years.Sixty-two cases died during follow -up, and the two-year survival rate was 0%.The mean overall survival of short -course concurrent chemoradiotherapy increased significantly ( P=0.002 ) compared to short-course radiotherapy -alone and TMZ-alone ( P=0.001 ) .It got more survival benefit for patients with negative MGMT (P=0.004).But there was no significant difference between short -course radiotherapy -alone and TMZ-alone (P>0.05).Conclusion Short-course concurrent chemotherapy may be a optimization adjuvant therapy plan to elderly patients with newly diagnosed GBM and poor post -operation performance , and this advantage is more obvi-ous in patients with MGMT promotor methylation .