Application Of Experimental Chemotherapy In Special Elderly Patients With High-grade Glioma

Background and objective:Glioma is the most common malignant tumor in intracranial,among which glioblastoma has the highest incidence and the highest degree of malignancy.The incidence of glioblastoma increases with age and is highest in the 75-80 age group.The current treatment methods for glioblastoma mainly include surgery,radiotherapy,chemotherapy,electric field therapy and comprehensive treatment.Surgery can not only define the pathological type of tumor,reduce the mass effect,reduce the burden of tumor,but also create opportunities for further treatment.Considering the tolerance of elderly patients to surgery,the commonly used surgical options are total resection,partial resection and stereotactic biopsy.However,a growing body of research suggests that even a small surgical trauma may affect several physiological processes,leading to postoperative metastatic spread and tumor recurrence.Some elderly patients are difficult to benefit from surgery due to age,underlying diseases,tumors located in functional areas or deep brain tissue,and some patients refuse stereotaxic biopsy.For the elderly patients whose imaging manifestations are highly consistent with the imaging characteristics of high-grade glioma and cannot be diagnosed pathologically,the application of experimental chemotherapy is still controversial.The purpose of this study was to analyze the effect of experimental chemotherapy in elderly patients with high-grade glioma.Methods:A retrospective analysis was conducted on 82 patients with high-grade glioma who were over 65 years old and admitted to the Tumor Hospital of Tianjin Medical University.Kaplan-Meier method was used to analyze the total and progression-free survival of the patients,and Cox regression model was used to analyze the independent risk factors affecting the total and progression-free survival of the patients.Subgroup analysis was performed to compare the effects of different treatment methods on patients’ OS and PFS.The EORTC QLQ-BN20(The Europe Organization for Research and Treatment of Cancer,Quality of Life Questionnaire‐Brain Cancer 20)scale was used to assess patients’ quality of life.T test was used to compare the difference of life quality of patients before and 6 months after receiving experimental chemotherapy,and to compare the difference of life quality of patients 6 months after receiving different treatment methods.Results:Through Kaplan-Meier analysis and Cox regression model analysis,it was found that whether there were underlying diseases,KPS score and treatment mode were independent risk factors affecting the prognosis of patients.Further analysis showed that experimental chemotherapy had significant survival benefits compared with surgery combined with adjuvant therapy in elderly patients(≥70 years),patients with low KPS scores and patients with underlying diseases.The EORTC QLQ-BN20 scale was used to evaluate the quality of life of the patients.After 6 months of experimental chemotherapy,the overall quality of life,language function and motor function of the patients were better than those before the experimental chemotherapy.The overall quality of life of patients receiving surgical combined adjuvant therapy was better than that of patients receiving experimental chemotherapy,but in the evaluation of language and motor function,the patients receiving experimental chemotherapy were better than those receiving surgical combined adjuvant therapy.Conclusions:The study analyzed the experimental chemotherapy in elderly patients with high-grade glioma in particular,the application of the results found for tumors located in the functional areas,deep brain tissue,and diffuse growth cannot achieve complete resection in elderly patients with high-grade glioma,experimental chemotherapy can bring benefit to their survival,especially to age 70 or higher,KPS < 80 points,with underlying disease,and experimental chemotherapy,in addition,experimental chemotherapy can significantly improve the patient’s quality of life.It has certain guiding significance to clinical practice.