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| 1 | Presentation,management,and outcome of newly diagnosed glioblastoma in elderly patients显示文摘OBJECT: Optimum management for elderly patients with newly diagnosed glioblastoma(GBM) in the temozolomide(TMZ) era is not well defined.The object of this study was to clarify outcomes in this population.METHODS: The authors retrospectively reviewed 105 consecutive cases involving elderly patients(age ≥ 65 years) with newly diagnosed GBM who were treated at the Mayo Clinic between 2003 and 2008.RESULTS: The patients' median age was 74 years(range 66-87 years),and the median Karnofsky Performance Status(KPS) score was 80(range 40-90).Half of the patients underwent biopsy and half underwent resection.Patients with deep-seated lesions(19 patients [18%]) or multifocal lesions(34 patients [32%]) were more likely to have biopsy than resection(p = 0.0001 and 0.0009,respectively).New persistent neurological deficits developed in 7 patients(6.7%).Postoperative hemorrhage occurred in 6 patients(5.7%),all of whom underwent biopsy.Complete follow-up data regarding adjuvant treatment was available in 84 patients.Forty-one(49%) were treated with chemotherapy(mostly TMZ) and radiation therapy(RT),and 23(27%) with RT alone.Nineteen(23%) received only palliative care after surgery(more common with biopsy,p = 0.03).Chemotherapy complications occurred in 28.6%(Grade 3 or 4 hematological complications in 11.9%).The median values for progression-free survival(PFS) and overall survival(OS) were 3.5 and 5.5 months.In a multivariate analysis,younger age(p = 0.03,risk ratio [RR] 0.34,95% CI 0.13-0.89),single lesion(p = 0.02,RR 0.51,95% CI 0.30-0.89),resection(p = 0.04,RR 0.54,95% CI 0.31-0.94),and adjuvant treatment(p = 0.0001,RR 0.24,95% CI 0.11-0.49) were associated with better OS.Only adjuvant treatment was significantly associated with prolonged PFS(p = 0.0007,RR 0.27,95% CI 0.13-0.57).With combined therapy with resection,RT,and chemotherapy,the median PFS and OS were 8 and 12.5 months,respectively.CONCLUSIONS: The prognosis for GBM worsens with increasing age in elderly patients.With important risks,resection and adjuvant treatment are associated with prolonged survival.Although selection bias cannot be excluded in this retrospective study,advanced age alone should not necessarily preclude optimal resection followed by adjuvant radiochemotherapy. | Tanaka S Meyer FB Buckner JC Uhm JH Yan ES Parney IF | 2013 | 中国神经肿瘤杂志2013,11,1: | 4 |
| 2 | A phase Ⅰ and pharmacokinetic study of temsirolimus (CCI-779) administered intravenously daily for 5 days every 2 weeks to patients with advanced cancer显示文摘 | HIDALGO M BUCKNER JC ERLICHMAN C | 2006 | Clln Cancer Res2006,12,19: | 1 |
| 3 | Management of recurrent meningeal hemangiopericytoma 显示文摘 | Galanis E Buckner JC Scheithauer BW | 1998 | Cancer1998,82,11: | 1 |
| 4 | Prostate specific antigen levels and clinical response to low dose dexamethasone for hormone-refractory metastatic prostate carcinoma显示文摘 | Storlie JA Buckner JC Wiseman GA | 1995 | Cancer1995,76,: | 1 |
| 5 | A phase I and pharmacokinetic study of temsirolimus (CCI-779) administered intravenously daily for 5 days every 2 weeks to patients with advanced cancer显示文摘 | Hidalgo M Buckner JC Erlichman C | 2006 | Clin Cancer Res2006,12,19: | 1 |
| 6 | Effects of radi- ation and chemotherapy on cognitive function in patients with high-grade glioma 显示文摘 | Taylor BV Buckner JC Cascino TL | 1998 | J Clin Oncol1998,16,6: | 1 |
| 7 | Clinical outcome of gliosarcoma compared with glioblastoma multifoume:north centual cancer treatment group results显示文摘 | Galanis E Buckner JC Dinapoli RP | 1988 | J Neurosurg1988,89,2: | 1 |
| 8 | Importance of baseline mini-mental state examination as a prognostic factor for patients with low-grade glioma 显示文摘 | LinksBrown PD Buckner JC O'Fallon JR | 2004 | Int J Radiat Oncol Biol Phys2004,59,1: | 1 |
| 9 | Mammalian target of rapamycin (mTOR) inhibitors as anti-cancer agents显示文摘 | Rao RD Buckner JC Sarkaria JN | 2004 | Curr Cancer Drug Targets2004,4,8: | 1 |
| 10 | Mammalian target of rapamycin (mTOR) inhibitors as anti-cancer agents显示文摘 | Rao RD Buckner JC Sarkaria JN | 2004 | Curr Cancer Drug Targets2004,4,8: | 1 |
| 11 | Factors influencing survival in high - grade gli- omas显示文摘 | Buckner JC | 2003 | Semin 0ncol2003,30,6: | 1 |
| 12 | Phase Ⅲ trial of car-mustine and cisplatin compared with carmustine alone and standard radiation therapy or accelerated radiation therapy in patients with glio-blastoma multiforme显示文摘 | Buckner JC Ballman KV Michalak JC | 2006 | J Clin Oncol2006,24,: | 1 |
| 13 | Factors influencing survival in high-grade gliomas 显示文摘 | Buckner JC | 2003 | Semin Oncol2003,30,619: | 1 |
| 14 | Effects of radiotherapy on cognitive function in patients with low-grade glioma measured by the folstein mini-mental state examination显示文摘 | Brown P D Buckner JC O' Fallon J R | 2003 | J Clin Oncol2003,21,13: | 1 |
| 15 | Adult patients with supratentorial pilocytic astrocytomas:a prospective multicenter clinical trial显示文摘 | Brown PD Buckner JC O Fallon JR | 2004 | Int J Radiat Oncol Biol Phys2004,58,4: | 1 |
| 16 | Phase Ⅱ trial of procarbazine, lomustine, and vincristine as initial therapy for patients with low-grade oligodendroglioma or oligoastrocytoma:efficacy and associations with chromosomal abnormalities显示文摘 | Buckner JC Gesme D Jr O' Fallon JR | 2003 | J Clin Oncol2003,21,2: | 1 |
| 17 | Phase II trial of primary chemotherapy followed by reduced-dose radiation for CNS germ cell tumors显示文摘 | Buckner JC Peethambaram PP Smithson WA | 1999 | J Clin Oncol1999,17,93: | 1 |
| 18 | Priming tissue-specific cellular immunity in a phase I trial of autologous dendritic cells for prostate canc- er显示文摘 | Burch PA Breen JK Buckner JC | 2000 | Clin Cancer Res2000,6,6: | 1 |
| 19 | Priming tissue-specific cellular immunity in a phase I trial of autologous Dendritic cells for prostate cancer显示文摘 | Burch PA Breen JK Buckner JC | 2000 | Clin Cancer Res2000,6,: | 1 |
| 20 | Phase Ⅱ trial of procarbazine,lomustine,and vincristine as initial therapy for patients with low-grade oligodendroglioma or oligoastrocytoma:efficacy and associations with chromosomal abnormalities显示文摘 | Buckner JC Gesme D Jr O fallon JR | 2003 | J Clin Oncol2003,21,1: | 1 |