中文摘要：

目的探讨短程放疗联合替莫唑胺（TMZ）方案在术后KPS评分较差的老年胶质母细胞瘤（GBM）患者治疗中的生存获益情况。方法回顾分析行完整切除但术后KPS评分不佳的新诊断老年GBM患者71例,对不同MGMT状态下各辅助治疗方案进行生存分析和比较。结果 71例患者年龄65~85岁,平均（71.10±5.19）岁,其中男50例,年龄（71.36±5.35）岁,女21例,年龄（70.48±4.90）岁;其中62例在随访截止日期前死亡,总体平均生存期（OS）（11.92±0.51）个月,2年生存率0;接受短程同步放化疗联合TMZ辅助治疗组平均生存期显著提高（P=0.002）,与单纯短程放疗组相比差异性最大（P=0.001）,而单纯短程放疗与单纯TMZ辅助治疗组之间OS差异无统计学意义（P〉0.05）;术后免疫组化MGMT阴性表达组患者更能从短程同步放化疗联合TMZ辅助化疗中获得生存获益（P=0.004）。结论对于≥65岁接受肿瘤切除后功能状态不佳的老年GBM患者,短程同步放化疗联合TMZ辅助治疗可能是一种能获得更多生存获益的术后辅助治疗方案,在MGMT启动子甲基化患者中,这种获益优势更加明显。

英文摘要：

Objective To investigate if a short- course concurrent chemoradiotherapy that yields a better mean survival in elderly patients with newly diagnosed glioblastoma multiforme（ GBM） and poor post- operation performance. Methods This study included 71 newly diagnosed primary GBM patients aged 65 years or older with poor post- operation KPS. Kaplan- Meier method stratified by MGMT status was used to compared the survival in different groups. Results The mean age was（ 71.10 ± 5.19） years old,among whom the mean age of 50 males was（ 71.36 ± 5.35） years,and of 21 females was（ 70.48 ± 4.90） years. Sixty- two cases died during follow- up,and the two- year survival rate was 0%. The mean overall survival of short- course concurrent chemoradiotherapy increased significantly（ P = 0.002）compared to short- course radiotherapy- alone and TMZ- alone（ P = 0.001）. It got more survival benefit for patients with negative MGMT（ P = 0.004）. But there was no significant difference between short- course radiotherapy- alone and TMZ- alone（ P〉0.05）. Conclusion Short- course concurrent chemotherapy may be a optimization adjuvant therapy plan to elderly patients with newly diagnosed GBM and poor post- operation performance,and this advantage is more obvious in patients with MGMT promotor methylation.