接受Stupp方案治疗的老年胶质母细胞瘤患者预后的影响因素

目的 探讨接受Stupp方案治疗的老年胶质母细胞瘤(GBM)患者预后的影响因素。 方法 分析2014年1月至2018年1月接受Stupp方案治疗的老年GBM患者病例资料,包括一般人口学、临床病例、Karnofsky功能状态(KPS)评分和分子标志物O6-甲基鸟嘌呤DNA甲基转移酶(MGMT)、异柠檬酸脱氢酶-1(IDH-1)、Ki67与TP53的表达等。通过Kaplan-Meier对总生存期(OS)、无进展生存期(PFS)进行单因素分析,Cox回归模型进行多因素比较。 结果 共纳入91例样本,49例(53.8%)Ki67≥30%,IDH野生型78例(85.7%),MGMT甲基化35例(38.5%),TP53蛋白阳性44例(48.4%);老年GBM患者1、3、5年OS分别为41.8%、12.8%、9.6%,1、3年PFS分别为16.5%、7.6%;KPS评分(HR=0.445,95%CI:0.265~0.745,P=0.002)、认知功能(HR=2.675,95%CI:1.051~6.089,P=0.039)、MGMT(HR=0.384,95%CI:0.218~0.675, P=0.001)、ki67(HR=1.855,95%CI:1.157~2.975,P=0.010)与老年GBM患者OS有统计学意义的关联性,KPS评分(HR=0.598,95%CI:0.358~0.998,P=0.049)、MGMT(HR=0.335,95%CI:0.187~0.601,P<0.001)、IDH-1(HR=0.437,95%CI:0.200~0.958,P=0.039)、Ki67(HR=1.958,95%CI:1.203~3.187,P=0.007)与GBM患者PFS有统计学意义的关联性。 结论 老年GBM患者预后差,KPS评分、认知功能、MGMT、IDH-1和Ki67可预测其预后。

Prognostic factors of elderly patients with glioblastoma treated with Stupp treatment

Objective To investigate the prognostic factors of elderly patients with glioblastoma(GBM)treated with Stupp treatment. Methods Clinical data of elderly GBM patients who received Stupp treatment during Jan. 2014 and Jan. 2018 were retrospectively analyzed, including demographic information, clinical characteristics, Karnofsky Performance Scale(KPS)score, molecular marker O6-methyl guanine DNA methyltransferase(MGMT), isocitrate dehydrogenase 1(IDH-1), expression of ki67 and TP53, and so on. Univariate analysis was performed on overall survival(OS)and progression-free survival(PFS)by Kaplan-Meier, and Cox regression model was used for multivariate comparison. Results A total of 91 samples were enrolled, including 49(53.8%)cases of Ki67≥30%, 78(85.7%)cases of IDH wild type, 35(38.5%)cases of MGMT methylation, and 44(48.4%)cases of TP53 protein positive. The 1-year, 3-year and 5-year OS were 41.8 %, 12.8%, and 9.6%, respectively. The 1-year and 3-year PFS were 16.5% and 7.6%, respectively. KPS score(HR=0.445, 95%CI: 0.265-0.745, P=0.002), cognitive function(HR=2.675, 95%CI: 1.051-6.089, P=0.039), MGMT(HR=0.384, 95%CI: 0.218-0.675, P=0.001), Ki67(HR=1.855, 95%CI: 1.157-2.975, P=0.010)were significantly associated with OS. KPS(HR=0.598, 95%CI: 0.358-0.998, P=0.049), MGMT(HR=0.335, 95%CI: 0.187-0.601, P<0.001), IDH-1(HR=0.437, 95%CI: 0.200-0.958, P=0.039), Ki67(HR=1.958, 95%CI: 1.203-3.187, P=0.007)were significantly associated with PFS. Conclusion The prognosis of elderly GBM patients is poor. KPS score, cognitive function, MGMT, IDH-1 and Ki67 can predict the prognosis.