Optimal Tedavi, Altmış Beş Yaş ve Üstü Glioblastome Multiforme Tanılı Hastalarda Sağkalım Üzerine Etkili mi?

Amaç: Glioblastoma Multiforme (GBM) erişkinlerde en sık görülen primer malign beyin tümörüdür. Optimal tedavisi, mümkün olan en geniş cerrahi rezeksiyon (maksimum güvenli rezeksiyon) sonrasında adjuvan eşzamanlı kemoradyoterapi ve ardından adjuvan kemoterapidir. Fakat, geriatrik grup optimal tedavi edilmemektedir. Son çalışmalarda genç hastalarla benzer olarak yaşlı grupta da optimal tedavinin fayda sağladığı gösterilmiştir. Biz de, 65 yaş ve üstü GBM’li hastalarda optimal tedavinin sağkalım üzerine etkisini araştırmayı amaçladık. Yöntemler: Pamukkale Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Polikliniğinde 2010-2018 yılları arasında takip edilen GBM patolojik tanılı 71 hastanın dosyaları retrospektif olarak değerlendirildi. Hastaların demografik ve klinikopatolojik özellikleri dosyadan kaydedildi Bulgular: Değerlendirilen 71 hastanın 25’i (%35,2) 65 yaş ve üstü, 46’sı (%64,8) 65 yaş altındaydı. Yirmi beş hastanın 11’i (%44) erkek, 14’ü (%56) kadındı. Tüm hasta grubunda ortanca takip süresi 16,2 ay (12,4-19,9), ortanca genel sağkalım süresi 12,5 ay (10,4-14,7 ay) idi. Altmış beş yaş altı hastaların ortanca genel sağkalımı 15,1 ay (12,6-17,6 ay), 65 yaş ve üstü hastaların ise 8,6 ay (7,9-9,3 ay) idi (p

Is Optimal Treatment Effective on Survival in Patients Diagnosed with Glioblastome Multiforme of Sixty-Five Years and Over?

Objective: Glioblastoma Multiforme (GBM) is the most common primary malignant brain tumor in adults. Optimal treatment is adjuvant concomitant chemoradiotherapy following the widest possible surgical resection (maximum safe resection) followed by adjuvant chemotherapy. However, the geriatric group is not treated optimally. Recent studies have shown that optimal treatment benefits in the older group, similar to those in younger patients.We aimed to investigate the effect of optimal treatment on survival in patients 65 years of age and older with GBM. Methods: In Pamukkale University Medical Oncology Clinic, the files of 71 patients with a pathological diagnosis of GBM between 2010 and 2018 were retrospectively evaluated.Demographic and clinicopathological characteristics of the patients were recorded from the file. Results: Of the 71 patients evaluated, 25 (35.2%) were 65 and over, 46 (64.8%) were under 65 years old. Of the twentyfive patients, 11 (44%) were male and 14 (56%) were female. Median follow-up time was 16.2 months (12.4-19.9) and median overall survival time was 12.5 months (10.4-14.7) in all patient groups. The median overall survival of patients under the age of 65 years was 15.1 months (12.6-17.6 months), and patients aged 65 and over were 8.6 months (7.9-9.3 months) (p

___

  • 1. Scott JG, Bauchet L, Fraum TJ, et al. Recursive partitioning analysis of prognostic factors for glioblastoma patients aged 70 years or older.Cancer 2012; 118: 5595-5600.
  • 2. Iwamoto FM, Reiner AS, Nayak L, et al. Prognosis and patterns of care in elderly patients with glioma. Cancer 2009; 115: 5534-40.
  • 3. Wick W, Platten M, Meisner C, et al. Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomised, phase 3 trial. Lancet Oncol 2012; 13: 707-15.
  • 4. Noorbakhsh A, Tang JA, Marcus LP, et al. Gross total resection outcomes in an elderly population with glioblastoma: a SEER-based analysis. J Neurosurg 2014; 120: 31-9.
  • 5. Vuorinen V, Hinkka S, Färkkilä M, Jääskeläinen J. Debulking or biopsy of malignant glioma in elderly people - a randomised study. Acta Neurochir (Wien) 2003; 145: 5-10.
  • 6. Chaichana KL, Chaichana KK, Olivi A, et al. Surgical outcomes for older patients with glioblastoma multiforme: Preoperative factors associated with decreased survival. Clinical article. J Neurosurg 2011; 114: 587-94.
  • 7. Almenawer SA, Badhiwala JH, Alhazzani W, et al. Biopsy versus partial versus gross total resection in older patients with high-grade glioma: a systematic review and meta-analysis. Neuro Oncol 2015; 17: 868-81.
  • 8. Babu R, Komisarow JM, Agarwal VJ, et al. Glioblastoma in the elderly: the effect of aggressive and modern therapies on survival. J Neurosurg 2016; 124: 998-1007.
  • 9. Zou Y, Bai HX, Wang Z, Yang L. Biopsy versus resection in the management of high-grade gliomas in the elderly. Neuro Oncol 2015; 17: 901-3.
  • 10. Perry JR, Laperriere N, O'Callaghan CJ, et al. Short-Course Radiation plus Temozolomide in Elderly Patients with Glioblastoma. N Engl J Med 2017; 376: 1027-37.
  • 11. Kayalı İ, Habiboğlu R, Sarıcanbaz İ, Lehimcioğlu Y. Hypofractıonated Radıotherapy And Concomıtant Temozolomıde For Hıgh-Grade Glıal Tumors In Elderly Patıents. Turk J Gerıatr. 2019; 22: 32-7.
  • 12. Aktan M, Kanyılmaz G, Benli Yavuz B, Koç M. Yüksek Gradlı Glial Tümörlerde Prognostik Faktörler ve Tedavi Sonuçlarımız: Tek Merkez Deneyimi. Selcuk Med J 2018; 34: 143-7.
  • 13. Fiorentino A, Balducci M, De Bonis P, et al. Can elderly patients with newly diagnosed glioblastoma be enrolled in radiochemotherapy trials? Am J Clin Oncol 2015; 38: 23-7.
  • 14. Rusthoven CG, Koshy M, Sher DJ, et al. Combined Modality Therapy With Radiation and Chemotherapy for Elderly Patients With Glioblastoma in the Temozolomide Era: A National Cancer Database Analysis. JAMA Neurol 2016; 73: 821-8.
  • 15. Cao JQ, Fisher BJ, Bauman GS, et al. Hypofractionated radiotherapy with or without concurrent temozolomide in elderly patients with glioblastoma multiforme: a review of ten-year single institutional experience. J Neurooncol 2012; 107: 395-405.
  • 16. Franceschi E, Depenni R, Paccapelo A, et al. Which elderly newly diagnosed glioblastoma patients can benefit from radiotherapy and temozolomide? A PERNO prospective study. J Neurooncol 2016; 128: 157-62.
  • 17. Keime-Guibert F, Chinot O, Taillandier L, et al. Radiotherapy for glioblastoma in the elderly. N Engl J Med 2007; 356: 1527-35.
  • 18. Brandes AA, Franceschi E, Tosoni A, et al. Temozolomide concomitant and adjuvant to radiotherapy in elderly patients with glioblastoma: correlation with MGMT promoter methylation status. Cancer 2009; 115: 3512-8.
Dicle Tıp Dergisi-Cover
  • ISSN: 1300-2945
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1963
  • Yayıncı: Cahfer GÜLOĞLU
Sayıdaki Diğer Makaleler

Mutation Analysis of Beta-Thalassemia Major Patients and Their Parents in Diyarbakir Province, Turkey

Cemal POLAT, Nuriye METE, Murat SÖKER

Investigation of the 1249G>A Genetic Variation of ABCC2 Drug Transporter Gene in the Turkish Population

Zuhal UÇKUN ŞAHİNOĞULLARI

İlk Anjiografisi Negatif Olan Spontan Subaraknoid Kanamalarda Anjiografi Tekrarının Gereksinimi Nedir?

Ayça ÖZKUL, Abdullah TOPCU

İleri Evre Medüller Tiroid Kanseri Tedavisinde Tirozin Kinaz İnhibitörü Kullanımı-Tek Merkez Deneyimi

Senar EBINC, Zeynep ORUÇ, Zuhat URAKÇI, Muhammet Ali KAPLAN, Mehmet KÜÇÜKÖNER, Abdurrahman IŞIKDOĞAN

Akut İskemik İnmede İntravenöz Trombolitik Tedavi: Türkiye'deki Üçüncü Basamak Bir Hastanenin Deneyimleri

Murat YILMAZ, Handan TEKER, Merve ÖNERLİ YENER, Muhammed Nur ÖGÜN, Edip GÜLTEKİN

Apoptotic and Anti-inflammatory Effects of Hypericum Perforatum Extract in Human Basal Cell Carcinoma TE 354.T Cell Line

Ebru CELIK, Halil Mahir KAPLAN, Ergin ŞİNGİRİK, Muhammed Salih ÇELİK, Harun ALP

Measurement of Glomerular Area in Primary Glomerular Diseases With a Digital Pathology Software

Didem TURGUT, Aysel ÇOLAK, Simal KÖKSAL CEVHER, Ezgi COŞKUN YENİGÜN, Fatih DEDE

Geriatrik Populasyonda Baş Boyun Cilt, Ciltaltı Tümöral Lezyonlarının İncelenmesi

Ragıp Onur ÖZTORNACI, Talih ÖZDAŞ, Emin KAPI, Kemal Koray BAL, Sedat ALAGÖZ, Elif Burcu ŞENYURT, Asiye Merve ERDOĞAN

Yüksek septal deviasyonda, septal inceltme ve bilateral spreader greftin internal nasal valv açısına etkisinin radyolojik olarak incelenmesi

Rana KAPUKAYA, Asena Ayça ÖZDEMİR

The reasons for conversion from laparoscopic appendectomy to open surgery in children: the first experience on 100 cases in a single center

Ali Erdal KARAKAYA