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Prognostic factors of elderly patients with glioblastoma treated with Stupp treatment
- SHI Xiaohan, LI Huayu, LI Feng
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Journal of Shandong University (Health Sciences). 2022, 60(10):
42-48.
doi:10.6040/j.issn.1671-7554.0.2022.0091
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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.