ABSTRACT
OBJECTIVE: To evaluate the effects of combined treatments on the outcome and survival of elderly (≥ 65 years) patients with glioblastoma as compared with younger ones. MATERIAL AND METHODS: Fifty consecutive elderly (≥ 65 years) patients (group A) who underwent complete or subtotal (> 80%) resection of brain glioblastoma followed by irradiation and chemotherapy with temozolomide between 2004 and 2009 were retrospectively reviewed and compared with 50 glioblastoma patients aged < 65 years, treated in the same period (group B). Patient sex, tumor location, size and side, combined treatments, reoperation, progression-free survival, and overall survival were compared in the two groups by using the Kaplan-Meyer method. RESULTS: There were no significant differences between the two groups for tumor location, size and side, and Ki-67 Li. Forty-four of 50 group B patients were treated by the Stupp protocol, whereas all group A patients underwent irradiation and adjuvant temozolomide. Second-line chemotherapy was administrated in 32% of group A and 76% of group B cases, and reoperation was performed in 16% and 36%, respectively. The median survival of the overall series of 100 patients was 15.6 months. Group A patients (≥ 65 years) had a median survival of 14.5 months, significantly lower than group B cases (17 months) (p = 0.02). CONCLUSION: Elderly patients with glioblastoma may benefit from combined treatments, including surgery, radiotherapy, and chemotherapy. Although younger patients do survive longer than older ones, the difference of survival is less significant if several criteria of selection to surgery, such as good Karnofsky performance status (KPS), largely resectable tumor, and no significant comorbidity, are respected.
Subject(s)
Brain Neoplasms/mortality , Brain Neoplasms/surgery , Glioblastoma/mortality , Glioblastoma/surgery , Age Factors , Aged , Aged, 80 and over , Antineoplastic Agents, Alkylating/therapeutic use , Brain Neoplasms/drug therapy , Brain Neoplasms/radiotherapy , Combined Modality Therapy , Craniotomy , Disease-Free Survival , Female , Glioblastoma/drug therapy , Glioblastoma/radiotherapy , Humans , Male , Prognosis , Reoperation , Retrospective Studies , Treatment OutcomeSubject(s)
Abducens Nerve Diseases/etiology , Cranial Nerve Neoplasms/complications , Neurilemmoma/complications , Trigeminal Nerve Diseases/complications , Cranial Nerve Neoplasms/surgery , Diplopia/etiology , Female , Headache/etiology , Humans , Magnetic Resonance Imaging , Neurilemmoma/surgery , Neurologic Examination , Neurosurgical Procedures , Treatment Outcome , Trigeminal Nerve Diseases/surgery , Young AdultABSTRACT
We report a patient with a hemorrhagic lesion encroaching upon the posterior third of the corpus callosum but sparing the splenium. She showed marked difficulties in recognizing objects and shapes perceived through her left hand, while she could appreciate elementary sensorial features of items tactually presented to the same hand flawlessly. This picture, corresponding to classical descriptions of unilateral associative tactile agnosia, was associated with finger agnosia of the left hand. This very unusual case report can be interpreted as an instance of disconnection syndrome, and allows a discussion of mechanisms involved in tactile object recognition.
Subject(s)
Agnosia/diagnosis , Corpus Callosum/pathology , Functional Laterality , Neural Pathways/pathology , Stereognosis , Adult , Agnosia/pathology , Agnosia/physiopathology , Discrimination, Psychological , Female , Hand/innervation , Humans , Psychomotor PerformanceABSTRACT
PURPOSE: To report a case of benign intracranial hypertension related to mesalazine use. DESIGN: Observational case report. METHODS: A 23-year-old-woman with sudden visual loss, headache, and a history of ulcerative colitis treated with mesalazine underwent ophthalmologic examination, echography, magnetic resonance imaging, and lumbar puncture. RESULTS: The examinations disclosed benign intracranial hypertension that resolved when mesalazine was discontinued and recurred when the drug was restarted. CONCLUSIONS: We recommend periodic ocular fundus examination for patients undergoing long-term therapy with mesalazine, especially if decreased vision, headaches, or neck stiffness are present, to avoid potentially severe complications of intracranial hypertension
