65 Yaş ve Üzeri Tek Odak Glioblastome Multiforme Hastalarında Gross Total Rezeksiyon Uygulanan ve Uygulanmayan Hastalarda Genel Sağ Kalım ve Kemoradyoterapiye Yanıt Farklılıkları

Amaç: Çalışmada, 65 yaş ve üzeri, tek odak glioblastome multiforme tanılı kemoradyoterapi almış hastalarda primer tümörün gross total rezeksiyonu uygulanan ve uygulanmayan gruplarda kemoradyoterapiye yanıtların ve sağ kalımların karşılaştırılmıştır. Gereç ve Yöntemler: 65 yaş ve üzeri, histolojik olarak kanıtlanmış glioblastome multiforme tanısı olan hastaların tek merkez verileri retrospektif olarak değerlendirilmiştir. Gross total rezeksiyon uygulanmış ve uygulanmamış hastaların radyoterapi eş zamanlı temozolamid tedavilerini tamamlamış olanlar tedavi yanıtları, progresyonsuz sağkalım, rekürrensiz sağkalım ve genel sağ kalım açısından analiz edilmiştir. Bulgular: Çalışmaya 55 hasta dahil edilmiştir. Genel yanıt oranı her iki grupta benzer izlendi %23,5 vs %23,8, p=0,984 . Her iki grupta medyan genel sağkalım 13 ay iken p=0,645 ; gross total rezeksiyon uygulanan kolda medyan rekürrenssiz sağ kalım 8 ay; gross total rezeksiyon uygulanmayan grupta medyan progresyonsuz sağ kalım 6 aydı. Median tümör çapı her iki grupta da 4 cm idi p=0,875 . Rekürrens veya progresyon sonrası kurtarma tedavisi alabilen hasta oranı benzerdi. Univariate analizde, cinsiyet HR 1,061 [%95CI 0,589-1,912]; p=0,844 , yaş HR 0,992 [%95CI 0,538-1,831]; p=0,980 , tümör çapı HR 0,740 [%95CI 0,411-1,333]; p=0,316 , primerin gross total rezeksiyonu HR 0,869 [%95CI 0,470-1,607]; p=0,653 genel sağ kalım üzerine etkili izlenmezken, sol beyin tümörlerinde HR 2,183 [%95CI 1,204-3,957]; p=0,010 genel sağ kalım daha uzun izlendi.Sonuç: Altmış beş yaş ve üstü tek odak glioblastoma multiforme hastalarında gross total rezeksiyon uygulanan ve uygulanmayan gruplar arasında kemoradyoterapi tedavi yanıt farkı ve genel sağ kalım farkı izlenmemiştir

Anahtar Kelimeler:

Yaşlı, GBM, Gross total rezeksiyon, Sağ kalım

Survival and Treatment Outcome Differences in Glioblastoma Multiforma Patients aged 65 years and over after Gross Total Resection Compared to Patients who did not undergo Gross Total Resection of a Single Lesion

Objective: In this study our aim was to compare treatment and survival outcomes of gross total resection among patients aged 65 years and over with single focus glioblastoma multiforme compared to patients who did not undergo gross total resection.Material and Methods: Data of patients aged 65 years or over with histologically proven glioblastome multiforme at a single center was retrospectively evaluated. Treatment response outcomes and survivals were analysed in patients who had completed radiotherapy concomitant with temozolomide according to the gross total resection profile. Results: A total of 55 patients were included in the study. Overall response rates were similar in both groups 23.5% vs 23.8, p=0.984 . Overall survival times were 13 months in both groups p=0.645 , median recurrence free survival was 8 months in gross total resected patients while median progression free survival was 6 months in the un-resected group. Median tumor size was 4 cm in both groups p=0.875 . The patient ratios who had salvage treatment after recurrence or progression were similar. Univariate analysis demonstrated that sex HR 1.061 [95%CI 0.589-1.912]; p = 0.844 , age HR 0.992 [95%CI 0.538-1.831]; p = 0.980 , tumor size HR 0.740 [95%CI 0.411-1.333]; p = 0.316 , gross total resection of tumor HR 0.869 [95%CI 0.470-1.607]; p = 0.653 had no advantage on overall survival, while left brain tumor location demonstrated improved survival, independently HR 2.183 [95%CI 1.204-3.957]; p = 0.010 .Conclusion: There is no difference in treatment outcomes in gross total resected and unresected groups. There were no differences in overall survivals in both gross total resected and un-resected patients

Keywords:

Elderly, GBM, Gross total resection, Survival,

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