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【文摘发布】中老年患者恶性胶质瘤的放射治疗
Author Florence Keime-Guibert, M.D., Olivier Chinot, M.D., Luc Taillandier, M.D., Stéphanie Cartalat-Carel, M.D., Marc Frenay, M.D., Guy Kantor, M.D., Jean-Sébastien Guillamo, M.D., Eric Jadaud, M.D., Philippe Colin, M.D., Pierre-Yves Bondiau, M.D., Philippe Meneï, M.D., Hugues Loiseau, M.D., Valérie Bernier, M.D., Jérôme Honnorat, M.D., Maryline Barrié, M.D., Karima Mokhtari, M.D., Jean-Jacques Mazeron, M.D., Anne Bissery, M.D., Jean-Yves Delattre, M.D., for the Association of French-Speaking Neuro-Oncologists
Resource: NEJM. April 12,2007,Volume 356:1527-1535.
ABSTRACT
Background There is no community standard for the treatment of glioblastoma in patients 70 years of age or older. We conducted a randomized trial that compared radiotherapy and supportive care with supportive care alone in such patients.
Methods Patients 70 years of age or older with a newly diagnosed anaplastic astrocytoma or glioblastoma and a Karnofsky performance score of 70 or higher were randomly assigned to receive supportive care only or supportive care plus radiotherapy (focal radiation in daily fractions of 1.8 Gy given 5 days per week, for a total dose of 50 Gy). The primary end point was overall survival; secondary end points were progression-free survival, tolerance of radiotherapy, health-related quality of life, and cognition.
Results We randomly assigned 85 patients from 10 centers to receive either radiotherapy and supportive care or supportive care alone. The trial was discontinued at the first interim analysis, which showed that with a preset boundary of efficacy, radiotherapy and supportive care were superior to supportive care alone. A final analysis was carried out for the 81 patients with glioblastoma (median age, 73 years; range, 70 to 85). At a median follow-up of 21 weeks, the median survival for the 39 patients who received radiotherapy plus supportive care was 29.1 weeks, as compared with 16.9 weeks for the 42 patients who received supportive care alone. The hazard ratio for death in the radiotherapy group was 0.47 (95% confidence interval, 0.29 to 0.76; P=0.002). There were no severe adverse events related to radiotherapy. The results of quality-of-life and cognitive evaluations over time did not differ significantly between the treatment groups.
Conclusions Radiotherapy results in a modest improvement in survival, without reducing the quality of life or cognition, in elderly patients with glioblastoma. (ClinicalTrials.gov number, NCT00430911 本人认领此文，已完成。
中老年患者恶性胶质瘤的放射治疗
Background There is no community standard for the treatment of glioblastoma in patients 70 years of age or older. We conducted a randomized trial that compared radiotherapy and supportive care with supportive care alone in such patients.
背景：对于70岁以上（含70岁）的老年恶性胶质瘤患者的治疗尚无公认的标准。我们设计了随机临床试验，比较研究对此类病人采用放疗加支持疗法与单独采用支持疗法的区别。
Methods Patients 70 years of age or older with a newly diagnosed anaplastic astrocytoma or glioblastoma and a Karnofsky performance score of 70 or higher were randomly assigned to receive supportive care only or supportive care plus radiotherapy (focal radiation in daily fractions of 1.8 Gy given 5 days per week, for a total dose of 50 Gy). The primary end point was overall survival; secondary end points were progression-free survival, tolerance of radiotherapy, health-related quality of life, and cognition.
方法：患者年龄在70或70岁以上，新诊断为多形性成胶质细胞瘤或恶性胶质细胞瘤。远期生活质量量表评分在70分以上（含70）。患者被随机分为两组，一组接受单一支持疗法，一组采用支持疗法加放疗。采取局部放疗，日照剂量1.8Gy，每周做5次放疗，总剂量50Gy。主要终点定为总存活数，次要终点定为无进展生存期、放疗耐受力、健康生活质量以及认知功能。
Results We randomly assigned 85 patients from 10 centers to receive either radiotherapy and supportive care or supportive care alone. The trial was discontinued at the first interim analysis, which showed that with a preset boundary of efficacy, radiotherapy and supportive care were superior to supportive care alone. A final analysis was carried out for the 81 patients with glioblastoma (median age, 73 years; range, 70 to 85). At a median follow-up of 21 weeks, the median survival for the 39 patients who received radiotherapy plus supportive care was 29.1 weeks, as compared with 16.9 weeks for the 42 patients who received supportive care alone. The hazard ratio for death in the radiotherapy group was 0.47 (95% confidence interval, 0.29 to 0.76; P=0.002). There were no severe adverse events related to radiotherapy. The results of quality-of-life and cognitive evaluations over time did not differ significantly between the treatment groups.
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作者:admin@医学,生命科学 2011-06-03 17:11
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