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A balanced score to predict survival of elderly patients newly diagnosed with glioblastoma.
Radiat. Oncol. 15:97 (2020)
BackgroundOver 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.MethodsOne hundred eighty one patients >= 65years 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>6months were summarized as Group A and B, respectively.ResultsAge, 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 2.7months) and group B (median OS of 7.8months). The score was of prognostic significance, independent of the adjuvant treatment regimen.ConclusionsThe 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.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Glioblastoma ; Elderly ; Score ; Adjuvant Treatment; Recursive Partitioning Analysis; Randomized Phase-iii; Prognostic-factors; Radiation-therapy; Adjuvant Temozolomide; Radiotherapy; Association; Reirradiation; Concomitant; Validation
ISSN (print) / ISBN
1748-717X
e-ISSN
1748-717X
Journal
Radiation Oncology
Quellenangaben
Volume: 15,
Issue: 1,
Article Number: 97
Publisher
BioMed Central
Publishing Place
Campus, 4 Crinan St, London N1 9xw, England
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Radiation Medicine (IRM)