(1) Background: Although the incidence of glioblastoma (GB) has a peak in patients aged 75–84 years, no standard treatment regimen for elderly patients has been established so far. The goal of this study was to analyze the outcome of GB patients ≥ 65 years to detect predictors with relevant impacts on overall survival (OS) and progression-free survival (PFS). (2) Methods: Medical records referred to our institution from 2006 to 2020 were analyzed. Adult GB patients with clinical data, postoperative MRI data, and ≥1 follow-up investigation after surgical resection were included. The complete cohort was divided into a younger (<65) and an elderly group (≥65 years). Multiple factors regarding OS and PFS were scanned using univariate and multivariable regression withp< 0.05. (3) Results: 1004 patients were included with 322 (61.0%) male individuals in the younger and 267 (56.1%) males in the older cohort. The most common tumor localization was frontal in both groups. Gross total resection (GTR) was the most common surgical procedure in both groups, followed by subtotal resection (STR) (145; 27.5%) in the younger group, and biopsy (156; 32.8%) in the elderly group. Multivariate analyses detected that in the younger cohort, MGMT promoter methylation and GTR were predictors for a longer OS, while MGMT methylation, GTR, and hypofractionated radiation were significantly associated with a longer OS in the elderly group. (4) Conclusions: Elderly patients benefit from surgical resection of GB when they show MGMT promoter methylation, undergo GTR, and receive hypofractionated radiation. Furthermore, MGMT methylation seems to be associated with a longer PFS in elderly patients. Further investigations are required to confirm these findings, especially within prospective radiation therapy studies and molecular examinations.
（1）背景：尽管胶质母细胞瘤（GB）的发病率在75-84岁患者中达到高峰，但迄今为止尚未建立针对老年患者的标准治疗方案。本研究旨在分析年龄≥65岁GB患者的预后，以识别对总生存期（OS）和无进展生存期（PFS）具有显著影响的预测因素。（2）方法：对2006年至2020年转诊至本机构的医疗记录进行分析。纳入标准为成年GB患者，需具备完整的临床资料、术后MRI数据以及至少一次手术切除后的随访记录。将完整队列分为年轻组（<65岁）和老年组（≥65岁）。采用单变量和多变量回归分析（p<0.05）筛选与OS及PFS相关的多重因素。（3）结果：共纳入1004例患者，其中年轻组男性322例（61.0%），老年组男性267例（56.1%）。两组最常见的肿瘤部位均为额叶。大体全切除（GTR）是两组最常见的手术方式，年轻组次之为次全切除（STR）（145例；27.5%），老年组次之为活检（156例；32.8%）。多变量分析显示，在年轻组中，MGMT启动子甲基化和GTR是较长OS的预测因素；而在老年组中，MGMT甲基化、GTR和大分割放疗均与较长OS显著相关。（4）结论：当老年患者存在MGMT启动子甲基化、接受GTR手术并采用大分割放疗时，可从GB手术切除中获益。此外，MGMT甲基化似乎与老年患者更长的PFS相关。仍需进一步研究验证这些发现，特别是在前瞻性放疗研究和分子检测领域。
肿瘤(癌症)患者之家