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Titolo:
Outcome in elderly patients undergoing definitive surgery and radiation therapy for supratentorial glioblastoma multiforme at a tertiary care institution
Autore:
Mohan, DS; Suh, JH; Phan, JL; Kupelian, PA; Cohen, BH; Barnett, GH;
Indirizzi:
Cleveland Clin Fdn, Dept Radiat Oncol, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 Oncol, Cleveland, OH 44195 USA Cleveland Clin Fdn, Dept Neurol, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 Neurol, Cleveland, OH 44195 USA Cleveland Clin Fdn, Dept Neurosurg, Cleveland, OH 44195 USA Cleveland ClinFdn Cleveland OH USA 44195 rosurg, Cleveland, OH 44195 USA Univ S Carolina, Sch Med, Columbia, SC USA Univ S Carolina Columbia SC USA iv S Carolina, Sch Med, Columbia, SC USA
Titolo Testata:
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
fascicolo: 5, volume: 42, anno: 1998,
pagine: 981 - 987
SICI:
0360-3016(199812)42:5<981:OIEPUD>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
SHORT-COURSE RADIOTHERAPY; MALIGNANT BRAIN-TUMORS; ANAPLASTIC GLIOMAS; STEREOTAXIC WAND; RESECTION; ASTROCYTOMA; FRAMELESS; EXTENT;
Keywords:
glioblastoma multiforme; elderly patients; radiotherapy; surgery;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Suh, JH Cleveland Clin Fdn, Dept Radiat Oncol, 9500 Euclid Ave,Desk T28, Cleveland, Cleveland Clin Fdn 9500 Euclid Ave,Desk T28 Cleveland OH USA 44195
Citazione:
D.S. Mohan et al., "Outcome in elderly patients undergoing definitive surgery and radiation therapy for supratentorial glioblastoma multiforme at a tertiary care institution", INT J RAD O, 42(5), 1998, pp. 981-987

Abstract

Purpose: To determine the efficacy of definitive surgery and radiation in patients aged 70 years and older with supratentorial glioblastoma multiforme. Methods and Materials: We selected elderly patients (greater than or equalto 70 years) who had primary treatment for glioblastoma multiforme at our tertiary care institution from 1977 through 1996. The study group (n = 102)included 58 patients treated with definitive radiation, 19 treated with palliative radiation, and 25 who received no radiation. To compare our results with published findings, we grouped our patients according to the applicable prognostic categories developed by the Radiation Therapy Oncology Group(RTOG): RTOG group IV (n = 6), V (n = 70), and VI (n = 26). Patients were retrospectively assigned to prognostic group IV, V, or VI based on age, performance status, extent of surgery, mental status, neurologic function, andradiation dose. Treatment included surgical resection and radiation (n = 49), biopsy alone (n = 25), and biopsy followed by radiation (n = 28). Patients were also stratified according to whether they were optimally treated (gross total or subtotal resection with postoperative definitive radiation) or suboptimally treated (biopsy, biopsy + radiation, surgery alone, or surgery + palliative radiation). Patients were considered to have a favorable prognosis (n = 39) if they were optimally treated and had a Karnofsky Performance Status (KPS) score of at least 70. Results: The median survival for patients according to RTOG groups IV, V, and VI was 9.2, 6.6, and 3.1 months, respectively (log-rank, p < 0.0004). The median overall survival was 5.3 months. The definitive radiation group (n = 58) had a median survival of 7.3 months compared to 4.5 months in the palliative radiation group (n = 19) and 1.2 months in the biopsy-alone group(p < 0.0001). Optimally treated patients had a median survival of 7.4 months compared to 2.4 months in those suboptimally treated (p < 0.0001). The favorable prognosis group had an 8.4-month median survival compared to 2.4 months in the unfavorable group (p < 0.0001). On multivariate analysis, the KPS, RTOG group, favorable/unfavorable prognosis, and optimal treatment/suboptimal treatment were significant predictors of survival. Conclusion: Elderly patients with good performance status (greater than orequal to 70 KPS) when treated aggressively with maximal resection and definitive radiation had longer survival than those treated with palliative radiation and biopsy. Aggressive treatment in such patients should be considered. (C) 1998 Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 07:48:35