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

发布时间：2018-02-25 23:35

  本文关键词： 老年 辅助治疗 胶质母细胞瘤 预后　出处：《广东医学》2017年01期 　论文类型：期刊论文

【摘要】：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(P0.05);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。
[Abstract]:Objective to investigate the survival benefits of short-course radiotherapy combined with temozolidomide in the treatment of elderly patients with glioblastoma with poor KPS score after operation. Methods New diagnosis with complete resection but poor postoperative KPS score was retrospectively analyzed. 71 elderly patients with GBM, Results 71 patients (50 males, 71.36 卤5.35) and 21 females (70.48 卤4.90) years old died before the deadline of follow-up, and 71 patients were 65 ~ 85 years old with an average age of 71.10 卤5.19 years, including 50 males (71.36 卤5.35) years old and 21 females (70.48 卤4.90) years old. The overall mean survival time was 11.92 卤0.51 months and the 2-year survival rate was 0. The mean survival time of the patients receiving short course radiotherapy and chemotherapy combined with TMZ adjuvant therapy was significantly higher than that of the simple short course radiotherapy group, and the difference was greatest compared with that of the simple short course radiotherapy group, while that of the simple short course radiotherapy group was higher than that of the simple TMZ group. There was no significant difference in OS between adjuvant treatment groups (P 0.05), and the survival benefit of patients with negative expression of immunohistochemical MGMT was more likely to be obtained from short course simultaneous radiotherapy and chemotherapy combined with TMZ adjuvant chemotherapy. Conclusion for patients 鈮，

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