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A balanced score to predict survival of elderly patients newly diagnosed with glioblastoma
BACKGROUND: Over the past years, several treatment regimens have been recommended for elderly patients with glioblastoma (GBM), ranging from ultrahypofractionated radiotherapy (RT) over monochemotherapy (ChT) to combined radiochemotherapy (RChT). The current guidelines recommend active treatment in...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201994/ https://www.ncbi.nlm.nih.gov/pubmed/32375830 http://dx.doi.org/10.1186/s13014-020-01549-9 |
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author | Straube, Christoph Kessel, Kerstin A. Antoni, Stefanie Gempt, Jens Meyer, Bernhard Schlegel, Juergen Schmidt-Graf, Friederike Combs, Stephanie E. |
author_facet | Straube, Christoph Kessel, Kerstin A. Antoni, Stefanie Gempt, Jens Meyer, Bernhard Schlegel, Juergen Schmidt-Graf, Friederike Combs, Stephanie E. |
author_sort | Straube, Christoph |
collection | PubMed |
description | BACKGROUND: Over the past years, several treatment regimens have been recommended for elderly patients with glioblastoma (GBM), ranging from ultrahypofractionated radiotherapy (RT) over monochemotherapy (ChT) to combined radiochemotherapy (RChT). The current guidelines recommend active treatment in elderly patients in cases with a KPS of at least 60%. We established a score for selecting patients with a very poor prognosis from patients with a better prognosis. METHODS: One hundred eighty one patients ≥65 years old, histologically diagnosed with GBM, were retrospectively evaluated. Clinical characteristics were analysed for their impact on the overall survival (OS). Factors which were significant in univariate analysis (log-rank test, p < 0.05) were included in a multi-variate model (multi-variate Cox regression analysis, MVA). The 9-month OS for the significant factors after MVA (p < 0.05) was included in a prognostic score. Score sums with a median OS of < and > 6 months were summarized as Group A and B, respectively. RESULTS: Age, KPS, MGMT status, the extent of resection, aphasia after surgery and motor dysfunction after surgery were significantly associated with OS on univariate analysis (p < 0.05). On MVA age (p 0.002), MGMT promotor methylation (p 0.013) and Karnofsky performance status (p 0.005) remained significant and were included in the score. Patients were divided into two groups, group A (median OS of 2.7 months) and group B (median OS of 7.8 months). The score was of prognostic significance, independent of the adjuvant treatment regimen. CONCLUSIONS: The score distinguishes patients with a poor prognosis from patients with a better prognosis. Its inclusion in future retrospective or prospective trials could help enhance the comparability of results. Before its employment on a routine basis, external validation is recommended. |
format | Online Article Text |
id | pubmed-7201994 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72019942020-05-09 A balanced score to predict survival of elderly patients newly diagnosed with glioblastoma Straube, Christoph Kessel, Kerstin A. Antoni, Stefanie Gempt, Jens Meyer, Bernhard Schlegel, Juergen Schmidt-Graf, Friederike Combs, Stephanie E. Radiat Oncol Research BACKGROUND: Over the past years, several treatment regimens have been recommended for elderly patients with glioblastoma (GBM), ranging from ultrahypofractionated radiotherapy (RT) over monochemotherapy (ChT) to combined radiochemotherapy (RChT). The current guidelines recommend active treatment in elderly patients in cases with a KPS of at least 60%. We established a score for selecting patients with a very poor prognosis from patients with a better prognosis. METHODS: One hundred eighty one patients ≥65 years old, histologically diagnosed with GBM, were retrospectively evaluated. Clinical characteristics were analysed for their impact on the overall survival (OS). Factors which were significant in univariate analysis (log-rank test, p < 0.05) were included in a multi-variate model (multi-variate Cox regression analysis, MVA). The 9-month OS for the significant factors after MVA (p < 0.05) was included in a prognostic score. Score sums with a median OS of < and > 6 months were summarized as Group A and B, respectively. RESULTS: Age, KPS, MGMT status, the extent of resection, aphasia after surgery and motor dysfunction after surgery were significantly associated with OS on univariate analysis (p < 0.05). On MVA age (p 0.002), MGMT promotor methylation (p 0.013) and Karnofsky performance status (p 0.005) remained significant and were included in the score. Patients were divided into two groups, group A (median OS of 2.7 months) and group B (median OS of 7.8 months). The score was of prognostic significance, independent of the adjuvant treatment regimen. CONCLUSIONS: The score distinguishes patients with a poor prognosis from patients with a better prognosis. Its inclusion in future retrospective or prospective trials could help enhance the comparability of results. Before its employment on a routine basis, external validation is recommended. BioMed Central 2020-05-06 /pmc/articles/PMC7201994/ /pubmed/32375830 http://dx.doi.org/10.1186/s13014-020-01549-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Straube, Christoph Kessel, Kerstin A. Antoni, Stefanie Gempt, Jens Meyer, Bernhard Schlegel, Juergen Schmidt-Graf, Friederike Combs, Stephanie E. A balanced score to predict survival of elderly patients newly diagnosed with glioblastoma |
title | A balanced score to predict survival of elderly patients newly diagnosed with glioblastoma |
title_full | A balanced score to predict survival of elderly patients newly diagnosed with glioblastoma |
title_fullStr | A balanced score to predict survival of elderly patients newly diagnosed with glioblastoma |
title_full_unstemmed | A balanced score to predict survival of elderly patients newly diagnosed with glioblastoma |
title_short | A balanced score to predict survival of elderly patients newly diagnosed with glioblastoma |
title_sort | balanced score to predict survival of elderly patients newly diagnosed with glioblastoma |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201994/ https://www.ncbi.nlm.nih.gov/pubmed/32375830 http://dx.doi.org/10.1186/s13014-020-01549-9 |
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