Postoperative treatment of primary glioblastoma multiforme with radiation and concomitant temozolomide in elderly patients
Postoperative treatment of primary glioblastoma multiforme with radiation and concomitant temozolomide in elderly patients
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DOI：
10.1016/j.ijrobp.2007.07.2368
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发表时间：
2008-03-15
影响因子：
7
通讯作者：
Schulz-Ertner, Daniela
中科院分区：
文献类型：
--
作者：
Combs, Stephanie E.;Wagner, Johanna;Schulz-Ertner, Daniela
目的：评价替莫唑胺（TMZ）对老年多形性胶质母细胞瘤（GBM）术后放化疗的疗效和毒副作用。患者与方法：对43例65岁及以上的原发性GBM患者进行TMZ术后放化疗治疗。初诊时的中位年龄为67岁；其中女性14例，男性29例。12例患者行完全手术切除，17例患者行次全切除，14例患者仅行活检。放射治疗的中位剂量为60戈瑞，中位剂量为5 x 2戈瑞/周。35例患者同时使用50mg /m(2)的TMZ， 8例患者使用75mg /m(2)的TMZ。仅5例患者给予TMZ辅助周期治疗。结果：所有患者的中位总生存期为11个月；精算总生存率为1年48%，2年8%。全切除后中位总生存期为18个月，次全切除后为16个月，活检后仅为6个月。中位无进展生存期为4个月；精算无进展生存率为6个月时41%，12个月时18%。大多数患者对放化疗耐受良好，43例患者中有38例可以不间断地完成放化疗。4例患者出现血液学副作用大于通用术语标准2级，导致1例患者早期停止TMZ治疗。结论：放化疗在老年GBM患者亚组中是安全有效的，在无重大合并症的患者中应予以考虑。(C) 2008爱思唯尔公司
Purpose: To evaluate efficacy and toxicity in elderly patients with glioblastoma multiforme (GBM) treated with postoperative radiochemotherapy with temozolomide (TMZ).Patients and Methods: Forty-three patients aged 65 years or older were treated with postoperative with radiochemotherapy using TMZ for primary GBM. Median age at primary diagnosis was 67 years; 14 patients were female, 29 were male. A complete surgical resection was performed in 12 patients, subtotal resection in 17 patients, and biopsy only in 14 patients. Radiotherapy was applied with a median dose of 60 Gy, in a median fractionation of 5 x 2 Gy/wk. Thirty-five patients received concomitant TMZ at 50 mg/m(2), and in 8 patients 75 mg/m(2) of TMZ was applied. Adjuvant cycles of TMZ were prescribed in 5 patients only.Results: Median overall survival was 11 months in all patients; the actuarial overall survival rate was 48% at I year and 8% at 2 years. Median overall survival was 18 months after complete resection, 16 months after subtotal resection, and 6 months after biopsy only. Median progression-free survival was 4 months; the actuarial progression-free survival rate was 41% at 6 months and 18% at 12 months. Radiochemotherapy was well tolerated in most patients and could be completed without interruption in 38 of 43 patients. Four patients developed hematologic side effects greater than Common Terminology Criteria Grade 2, which led to early discontinuation of TMZ in 1 patient.Conclusions: Radiochemotherapy is safe and effective in a subgroup of elderly patients with GBM and should be considered in patients without major comorbidifies. (C) 2008 Elsevier Inc.