Pattern of care and outcome in elderly patients with glioblastoma: Data in 151 patients from 3 Lombardia Hospitals
| Autor: | Antonio Silvani, Paola Gaviani, Andrea Rigamonti, Elio Agostoni, Gianluca Grimod, Valentina Prone, I. Milanesi, Andrea Salmaggi, F. Imbesi, Antonio Ardizzoia, Francesco Di Meco, Virginia Arienti |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Oncology medicine.medical_specialty Multivariate analysis medicine.medical_treatment Kaplan-Meier Estimate Neurosurgical Procedures law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans Aged Proportional Hazards Models Retrospective Studies Aged 80 and over Patterns of care Chemotherapy Brain Neoplasms business.industry Retrospective cohort study medicine.disease Combined Modality Therapy Surgery Radiation therapy Treatment Outcome Neurology 030220 oncology & carcinogenesis Multivariate Analysis Regression Analysis Female Neurology (clinical) Glioblastoma business Adjuvant 030217 neurology & neurosurgery |
| Zdroj: | Journal of the Neurological Sciences. 378:3-8 |
| ISSN: | 0022-510X |
| DOI: | 10.1016/j.jns.2017.04.030 |
| Popis: | The appropriate treatment approach for elderly patients with glioblastoma multiforme (GBM) is unclear, although different studies suggest survival benefit in fit patients treated with radiotherapy and chemiotherapy after surgery. We performed a retrospective analysis of 151 patients older than 65years with GBM treated in 3 Lombardia Hospitals. In univariate regression analysis higher KPS (p=0.02), macroscopical total resection (p0.003), radiotherapy (p0.0001), chemotherapy (p0.0001) and second line chemotheraphy (p=0.02) were of positive prognostic value. On the contrary older age (70years), presence of seizure at onset and additional resection after tumor recurrence did not influence OS. Multivariate analysis revealed radiotherapy (HR 0.2 p0.0001) and extent of surgery (HR 0.3, p=0,0063) as positive independent prognostic factors. Patients receiving radio-chemiotherapy displayed more treatment-related toxicities with a slightly prolonged OS versus those receiving hypofractionated radiotherapy. With the limits of a retrospective study, our data suggest that in elderly fit patients extensive surgery should be considered, moreover adjuvant treatments led to an increase in OS. Randomized controlled study are needed to develop treatment guidelines for elderly GBM patients and to assess whether the combination of post-surgical radio and chemiotherapy may be superior to hypofractionated radiotherapy and chemiotherapy in fit patients. |
| Databáze: | OpenAIRE |
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