title: Analysis of Treatment Tolerance and Factors Associated with Overall Survival in Elderly Patients with Glioblastoma.
abstract: BACKGROUND
  As the population ages, the proportion of elderly patients with glioblastomas has increased. Recently, many researchers have focused on the treatments available to and prognoses in elderly patients with glioblastomas.
  
  
  METHODS
  We conducted a retrospective study of glioblastoma patients aged 60 years old or older who were treated at the Neurosurgery Center at Beijing Tiantan Hospital from 2012 to 2014. Their clinical features, immunohistochemical characteristics, treatments, and outcomes were evaluated to determine treatment tolerance and identify prognostic factors.
  
  
  RESULTS
  Among the 70 included patients, the median survival time was 15 months. In the univariate analysis, patients who underwent a gross total resection had longer overall survival times than patients who had a subtotal resection (P < 0.05), and patients who received postoperative adjuvant therapy had longer overall survival times than those with no postoperative adjuvant therapy (P < 0.05). The expression of the p53 protein significantly affected overall survival. Patients with low p53 protein expression had a median survival of 17 months, whereas those who had high p53 protein expression had a median survival of 11.50 months (P < 0.05). Undergoing a gross total resection, receiving postoperative adjuvant therapy and having low p53 protein expression were factors that independently contributed to longer overall survival times in multivariate analysis.
  
  
  CONCLUSIONS
  Maximal safe surgical resection followed by radiotherapy with concurrent and adjuvant temozolomide significantly prolonged overall survival times and was well tolerated in elderly patients with glioblastomas. In addition, low p53 protein expression was a significant favorable prognostic indicator in this population.
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China.
authors.forename: Chaocai
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China.
authors.forename: Xingchao
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China.
authors.forename: Shuyu
authors.initials: S
authors.lastname: Hao
authors.affiliation: Department of Epidemiology and Health Statistics, Academy of Public Health and Management, Weifang Medical University, Weifang, China.
authors.forename: Zhaoping
authors.initials: Z
authors.lastname: Su
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China.
authors.forename: Yajie
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China.
authors.forename: Guidong
authors.initials: G
authors.lastname: Song
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China.
authors.forename: Lanbing
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China.
authors.forename: Jiangfei
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Ji
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Xie
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research for Neurological Diseases, Beijing, China. Electronic address: gaozx@ccmu.edu.cn.
authors.forename: Zhixian
authors.initials: Z
authors.lastname: Gao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005909:Glioblastoma / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019635:Neurosurgical Procedures; D011379:Prognosis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D000077204:Temozolomide; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D018906:Antineoplastic Agents, Alkylating; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D003606:Dacarbazine; D000077204:Temozolomide
keywords: Elderly; Glioblastoma; Prognosis; Treatment