Source:http://linkedlifedata.com/resource/pubmed/id/12389886
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
4
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| pubmed:dateCreated |
2002-10-22
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| pubmed:abstractText |
Many clinical trials have shown that the most important prognostic variable in patients with malignant glioma is advanced age. However, can some patients aged >60 years still have relatively good outcomes with conventional surgical and radiotherapeutic treatment? A previous audit of practice (1983-89) suggested that functional status was an important prognostic variable in the elderly. We have reviewed a further cohort (1989-96) to evaluate changes in practice and outcomes given advances in neuroimaging, neurosurgery and radiotherapy. The major findings in this series of 80 patients aged over 60 years with a histological diagnosis of supratentorial malignant glioma were: (i) There was a relationship between management undertaken and clinical status of the patients (p < 0.01), i.e. patients in good grade generally had tumour debulking and radiotherapy, whilst those in poor grade generally had only biopsy. (ii) There was a significant increase in survival of patients in the second period who received surgical debulking and post-operative radiotherapy (from a median of 23 to 41 weeks (p < 0.05). (iii) It is likely that case selection accounted for much of this improvement since there was a direct relationship between median survival time and good clinical grade using the WHO performance scale. (iv) A shorter radiotherapy course (30 Gy in six fractions) was as efficacious as a conventional course (60 Gy in 30 fractions), and those patients having radiotherapy survived significantly longer than those not having this treatment (p = 0.001). This study has again demonstrated the importance of preoperative clinical grade and radiotherapy treatment in determining outcomes in patients >60 years. To put these data in a societal context a recent prospective multicentre audit of patients with malignant glioma in Scotland, and another audit from our unit, showed that between 24 and 65% of patients aged >60 years, with a CT diagnosis of malignant glioma do not undergo either surgery or radiotherapy. Advanced age per se should not be a bar to interventional treatment in patients aged >60 years with suspected malignant glioma.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:status |
MEDLINE
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| pubmed:month |
Aug
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| pubmed:issn |
0268-8697
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:volume |
16
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
343-7
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| pubmed:dateRevised |
2004-11-17
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| pubmed:meshHeading |
pubmed-meshheading:12389886-Age Factors,
pubmed-meshheading:12389886-Aged,
pubmed-meshheading:12389886-Biopsy,
pubmed-meshheading:12389886-Brain Neoplasms,
pubmed-meshheading:12389886-Cohort Studies,
pubmed-meshheading:12389886-Female,
pubmed-meshheading:12389886-Glioblastoma,
pubmed-meshheading:12389886-Glioma,
pubmed-meshheading:12389886-Humans,
pubmed-meshheading:12389886-Male,
pubmed-meshheading:12389886-Middle Aged,
pubmed-meshheading:12389886-Preoperative Care,
pubmed-meshheading:12389886-Prognosis,
pubmed-meshheading:12389886-Treatment Outcome
|
| pubmed:year |
2002
|
| pubmed:articleTitle |
Management of patients aged >60 years with malignant glioma: good clinical status and radiotherapy determine outcome.
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| pubmed:affiliation |
Edinburgh Centre for Neuro-oncology, Department of Clinical Neurosciences, Western General Hospital, UK. irw@skull.dcn.ed.ac.uk
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| pubmed:publicationType |
Journal Article
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