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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 | Survival following surgery and prognostic factors for recently diagnosed malignant glioma:data from the Glioma Outcomes Project显示文摘 | Laws ER Parney IF Huang W | 2003 | J Neurosurg2003，99，3： | 1 |
| 3 | Technical hurdles in a pilot clinical trial of combined B7-2 and GM-CSF immunogene therapy for glioblastomas and melanomas显示文摘 | Parney IF Chang LJ Farr-Jones MA | | 0，，01： | 1 |
| 4 | 'Idiopath ic'cranial pachymeningitis responsive to anti tuberculous therapy, case report 显示文摘 | Parney IF Johnson ES Allen PB | 1997 | Neuro surgery1997，41，4： | 1 |
| 5 | Cytokine and cytokine receptor mRNA expression in human glioblastomas:evidence of Th1,Th2and Th3 cytokine dysregulation显示文摘 | Han C Parney IF Roa WH | 2002 | Acta Neuropathol2002，103，2： | 1 |
| 6 | Glioma immunology and inuramotherapy 显示文摘 | Parney IF Hao C Petruk KC | 2000 | Neurosmgery2000，46，4： | 1 |
| 7 | Current chemotherapy for glioblastoma显示文摘 | Parney IF Chang SM | 2003 | Ca- ncer journal2003，9，3： | 1 |
| 8 | Human glioma immunobiology in vitro:implications for immunogene therapy显示文摘 | Parney IF Farr-Jones MA Chang LJ | 2000 | Neurosurgery2000，46，5： | 1 |
| 9 | Survival following surgery and prognostic factors for recently diagnosed malignant glioma:data from the Glioma Outcomes Project显示文摘 | Laws ER Parney IF Huang W | 2003 | J Neurosurg2003，99，3： | 1 |
| 10 | Survival following sur- gery and prognostic factors for recently diagnosed malignant glioma :data from the Glioma Outcomes Project 显示文摘 | Laws ER Parney IF Huang W | 2003 | J Neuro- surg2003，99，3： | 1 |
| 11 | Glioma immunology and immunotherapy 显示文摘 | Hao CH Petruk KC | 2000 | Neurosurgery2000，46，： | 1 |
| 12 | Idiopat hic cranial hypert rophic pachymeningitis responsive to antitubereulous t herapy :a case report显示文摘 | Parney IF Johnson ES Allen PB | 1997 | Neurosurgery1997，41，4： | 1 |
| 13 | Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the glioma outcome project显示文摘 | Chang SM Parney IF McDermott | 2003 | J Neurosurg2003，98，6： | 1 |
| 14 | Glioma immunology and immunotherapy显示文摘 | Hao CH Petruk KC | 2000 | Neurosurgery2000，46，4： | 1 |
| 15 | I&opathlc crania hypertrophic pachymeningitis responsive to antituberculous therapy : a case report 显示文摘 | Parney IF Johnson ES Allen PB | 1997 | Neurosurgery1997，41，4： | 1 |
| 16 | GM-CSF and B7-2 combination imm unogene therapy in and allogeneic hu-PBL-SCID/beige mouse:Human glioblast oma multiforme model显示文摘 | Petruk KC Zhang C | 1997 | Hum Gene Ther1997，8，3： | 1 |
| 17 | Cytokine and cytokine re- ceptor mRNA expression in human glioblastomas: evidence of Thl, Th2 and Th3 cytokine dysregulation显示文摘 | Hao C Parney IF Roa WH | 2002 | Aeta Neuro- pathol2002，103，2： | 1 |
| 18 | Glioma immunology and immunotherapy 显示文摘 | Parney IF Hao C Petruk KC | 2000 | Neurosurgery2000，46，4： | 1 |
| 19 | Cytokine and cytokine receptor mRNA expression in human glioblastomas:evidence of Th1,Th2 and Th3 cytokine dysregulation显示文摘 | Hao C Parney IF Roa WH | 2002 | Acta Neuropathol2002，103，2： | 1 |
| 20 | Survival following surgery and prognostic factors for recently diagnosed malignant glioma: data from the Glioma Outcomes Project显示文摘 | Laws ER Parney IF Huang W | 2003 | J Neurosurg2003，99，3： | 1 |
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