Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (10): 42-48.doi: 10.6040/j.issn.1671-7554.0.2022.0091

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Prognostic factors of elderly patients with glioblastoma treated with Stupp treatment

SHI Xiaohan1, LI Huayu1, LI Feng2   

  1. 1. School of Nursing and Rehabilitation, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Neurosurgery, Affiliated Cancer Hospital of Shandong First Medical University, Jinan 250117, Shandong, China
  • Published:2022-09-30

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Abstract: Objective To investigate the prognostic factors of elderly patients with glioblastoma(GBM)treated with Stupp treatment. Methods Clinical data of elderly GBM patients who received Stupp treatment during Jan. 2014 and Jan. 2018 were retrospectively analyzed, including demographic information, clinical characteristics, Karnofsky Performance Scale(KPS)score, molecular marker O6-methyl guanine DNA methyltransferase(MGMT), isocitrate dehydrogenase 1(IDH-1), expression of ki67 and TP53, and so on. Univariate analysis was performed on overall survival(OS)and progression-free survival(PFS)by Kaplan-Meier, and Cox regression model was used for multivariate comparison. Results A total of 91 samples were enrolled, including 49(53.8%)cases of Ki67≥30%, 78(85.7%)cases of IDH wild type, 35(38.5%)cases of MGMT methylation, and 44(48.4%)cases of TP53 protein positive. The 1-year, 3-year and 5-year OS were 41.8 %, 12.8%, and 9.6%, respectively. The 1-year and 3-year PFS were 16.5% and 7.6%, respectively. KPS score(HR=0.445, 95%CI: 0.265-0.745, P=0.002), cognitive function(HR=2.675, 95%CI: 1.051-6.089, P=0.039), MGMT(HR=0.384, 95%CI: 0.218-0.675, P=0.001), Ki67(HR=1.855, 95%CI: 1.157-2.975, P=0.010)were significantly associated with OS. KPS(HR=0.598, 95%CI: 0.358-0.998, P=0.049), MGMT(HR=0.335, 95%CI: 0.187-0.601, P<0.001), IDH-1(HR=0.437, 95%CI: 0.200-0.958, P=0.039), Ki67(HR=1.958, 95%CI: 1.203-3.187, P=0.007)were significantly associated with PFS. Conclusion The prognosis of elderly GBM patients is poor. KPS score, cognitive function, MGMT, IDH-1 and Ki67 can predict the prognosis.

Key words: Glioblastoma, Elderly, Prognosis, Stupp treatment

CLC Number: 

  • R449
[1] Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma[J]. N Engl J Med, 2005, 352(10): 987-996.
[2] Ostrom QT, Cioffi G, Gittleman H, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2012-2016[J]. Neuro Oncol, 2019, 21(Suppl 5): v1-v100.
[3] Ostrom QT, Kinnersley B, Armstrong G, et al. Age-specific genome-wide association study in glioblastoma identifies increased proportion of ‘lower grade glioma’-like features associated with younger age[J]. Int J Cancer, 2018, 143(10): 2359-2366.
[4] 欧阳辉, 穆林森, 鲁明. 积极治疗老年胶质瘤[C] //第十五届中国医师协会神经外科医师年会摘要集. 深圳: 中国医师协会神经外科医师分会, 2020: 732.
[5] Glaser SM, Dohopolski MJ, Balasubramani GK, et al. Glioblastoma multiforme(GBM)in the elderly: initial treatment strategy and overall survival[J]. J Neurooncol, 2017, 134(1): 107-118.
[6] Alvarez DES, Alvarez-Vega MA, Balbin M, et al. Prognostic factors and survival study in high-grade glioma in the elderly[J]. Br J Neurosurg, 2016, 30(3): 330-336.
[7] Han Q, Liang H, Cheng P, et al. Subtotal resection on survival outcomes in elderly patients with high-grade glioma: a systematic review and meta-analysis[J]. Front Oncol, 2020, 10: 151. doi: 10.3389/fonc.2020.00151.
[8] Barbagallo G, Altieri R, Garozzo M, et al. High grade glioma treatment in elderly people: is it different than in younger patients? analysis of surgical management guided by an intraoperative multimodal approach and its impact on clinical outcome[J]. Front Oncol, 2020, 10: 631255. doi: 10.3389/fonc.2020.631255.
[9] Young JS, Chmura SJ, Wainwright DA, et al. Management of glioblastoma in elderly patients[J]. J Neurol Sci, 2017, 380: 250-255. doi: 10.1016/j.jns.2017.07.048.
[10] Pirkkalainen JM, Jaaskelainen AS, Halonen P. Retrospective single-center study on elderly patients with glioblastoma between 2014 and 2018 evaluating the effect of age and performance status on survival[J]. Neurooncol Pract, 2022, 9(2): 142-148.
[11] Youland RS, Schomas DA, Brown PD, et al. Patterns of care and treatment outcomes in older adults with low grade glioma: a 50-year experience[J]. J Neurooncol, 2017, 133(2): 339-346.
[12] Laigle-Donadey F, Greffard S. Management of glioblastomas in the elderly population[J]. Rev Neurol(Paris), 2020, 176(9): 724-732.
[13] Ene CI, Cimino PJ, Fine HA, et al. Incorporating genomic signatures into surgical and medical decision-making for elderly glioblastoma patients[J]. Neurosurg Focus, 2020, 49(4): E11. doi: 10.3171/2020.7. FOCUS 20418.
[14] Fu C, Li Z, Mao Z. Association between social activities and cognitive function among the elderly in china: a cross-sectional study[J]. Int J Environ Res Public Health, 2018, 15(2): 231.
[15] Brown PD, Chung C, Liu DD, et al. A prospective phase II randomized trial of proton radiotherapy vs intensity-modulated radiotherapy for patients with newly diagnosed glioblastoma[J]. Neuro Oncol, 2021, 23(8): 1337-1347.
[16] Johnson DR, Sawyer AM, Meyers CA, et al. Early measures of cognitive function predict survival in patients with newly diagnosed glioblastoma[J]. Neuro Oncol, 2012, 14(6): 808-816.
[17] Louis DN, Perry A, Wesseling P, et al. The 2021 WHO classification of tumors of the central nervous system: a summary[J]. Neuro Oncol, 2021, 23(8): 1231-1251.
[18] Wick W, Weller M, van den Bent M, et al. MGMT testing-the challenges for biomarker-based glioma treatment[J]. Nat Rev Neurol, 2014, 10(7): 372-385.
[19] Pirozzi CJ, Yan H. The implications of IDH mutations for cancer development and therapy[J]. Nat Rev Clin Oncol, 2021, 18(10): 645-661.
[20] Zhao F, Zhang J, Li P, et al. Prognostic value of Ki-67 index in adult medulloblastoma after accounting for molecular subgroup: a retrospective clinical and molecular analysis[J]. J Neurooncol, 2018, 139(2): 333-340.
[21] Kawasoe T, Takeshima H, Yamashita S, et al. Detection of p53 mutations in proliferating vascular cells in glioblastoma multiforme[J]. J Neurosurg, 2015, 122(2): 317-323.
[22] Wang Q, Hu B, Hu X, et al. Tumor evolution of glioma-intrinsic gene expression subtypes associates with immunological changes in the microenvironment[J]. Cancer Cell, 2018, 33(1): 152.
[23] 李培栋, 王新军, 单峤, 等. 脑胶质瘤细胞MGMT甲基化状态与细胞对烷化剂耐药性的关系[J]. 中国老年学杂志, 2015, 35(16): 4463-4464.
[24] Kim BS, Kong DS, Seol HJ, et al. MGMT promoter methylation status as a prognostic factor for the outcome of gamma knife radiosurgery for recurrent glioblastoma[J]. J Neurooncol, 2017, 133(3): 615-622.
[25] Eckel-Passow JE, Lachance DH, Molinaro AM, et al. Glioma Groups Based on 1p/19q, IDH, and TERT Promoter Mutations in Tumors[J]. N Engl J Med, 2015, 372(26): 2499-2508.
[26] Louis DN, Giannini C, Capper D, et al. cIMPACT-NOW update 2: diagnostic clarifications for diffuse midline glioma, H3 K27M-mutant and diffuse astrocytoma/anaplastic astrocytoma, IDH-mutant[J]. Acta Neuropathol, 2018, 135(4): 639-642.
[27] Ceccarelli M, Barthel FP, Malta TM, et al. Molecular profiling reveals biologically discrete subsets and pathways of progression in diffuse glioma[J]. Cell, 2016, 164(3): 550-563.
[28] Luo Y, Zhang X, Mo M, et al. High Ki-67 immunohistochemical reactivity correlates with poor prognosis in bladder carcinoma: a comprehensive meta-analysis with 13,053 patients involved[J]. Medicine(Baltimore), 2016, 95(15): e3337. doi: 10.1097/MD.0000000000003337.
[29] Petrelli F, Viale G, Cabiddu M, et al. Prognostic value of different cut-off levels of Ki-67 in breast cancer: a systematic review and meta-analysis of 64,196 patients[J]. Breast Cancer Res Treat, 2015, 153(3): 477-491.
[30] Johannessen AL, Torp SH. The clinical value of Ki-67/MIB-1 labeling index in human astrocytomas[J]. Pathol Oncol Res, 2006, 12(3): 143-147.
[31] Preusser M, Hoeftberger R, Woehrer A, et al. Prognostic value of Ki67 index in anaplastic oligodendroglial tumours-a translational study of the European Organization for Research and Treatment of Cancer Brain Tumor Group[J]. Histopathology, 2012, 60(6): 885-894.
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