Метою дослідження була оцінка динаміки якості життя у пацієнтів похилого віку, прооперованих з приводу гліобластоми
півкуль головного мозку. Показано, що у даної групи цацієнтів відбувається зниження якості життя по всіх основних субшкалах. При цьому рівень фізичного дефіциту визначеного за шкалою Карновського корелює з показниками фізичного функціонування та рольового емоційного функціонування шкали MOS SF-36 (r = 0,61 and r = 0,59 відповідно). Впровадження сучасних нейронавігаційних технологій дозволяє покращити якість життя хворих на гліобластоми півкуль великого мозку похилого віку але не впливає на терміни виживання у
післяопераційному періоді.
The aim of the study was the evaluation of quality of life in elderly patients operated for glioblastomas of
cerebral hemispheres.
The research was conducted in the clinical departments of RC Institute of Neurosurgery n. a. AP Romodanov NAMS
of Ukraine (Kyiv, Ukraine) in 1999-2013.
During the observation period were registered 293 cases of intracerebral tumors of the cerebral hemispheres in
elderly and senile patients (study group) and 144 cases of surgical treatment of patients 18 to 59 years (control group).
Selection of patients was carried out during the period 1999-2013’s. It included all cases of surgical treatment of
intracerebral tumors of the cerebral hemispheres in young and middle-aged in the clinic intracerebral tumors each year
in a randomized selected month (April).
Starting in 2011, used the system of neuronavigation, which included the use of modern methods of medical imaging
for preoperative stage, followed by spatial modeling.
Preoperative planning included segmentation and Trace Contour tumors, determine the area of perifocal edema
spread, building bulk topographic image topography of the cerebral hemispheres, konvexitally located vascular
pathways of white matter, lateral ventricles, optimal trajectory and extent of surgical approach.
When planning tactics surgery and extent of tumor removal took into account clinical features, topohrafoanatomichne,
topographic and functional relationship of the tumor to surrounding anatomical entities.
Surgery interventions were performed using the navigation system StealthStation Treon Plus (Medtronic, USA).
For noninvasive and more complete removal of the tumor, extending into the functionally important zones and median
structure, the method of laser thermal degradation. Surgical resection of the tumor volume was determined by the
results of CT and MRI. The functional status of patients evaluated in the dynamics before and after surgery using
Karnovsky’s scale.
Assessment of quality of life (QOL) was carried out using a questionnaire SF-36 by the standard method before and
after treatment. Statistical analysis was carried out using the package Statistica 10.0 (StatSoft Inc., USA).
Intracerebral tumors localized in the frontal lobe in 54.8 % of cases, parietal – at 35.0 %, the temporal lobe – at
36.9 %, occipital – 12.7 %. Distribution of PHM on median structures found in 21.7 %. Every second patient was affected
by the tumor more than two lobes.
In both groups, observations dominated men (study group – 57.0 % control – 59.0 %). The average age of the
patients of the main group was 64,62 ± 0,9 years. A pervasive feature of a cohort of elderly patients was a significant
incidence of concomitant cardiovascular disease (in 93.8 %). By contrast, in the control group, only 34.1 % were
manifestations of diseases of the cardiovascular system without marked functional disorders.
The average value of Karnovsky’s index in the main group was at the time of admission to hospital was 61,94 ± 2,2
points, and at discharge – 68,31 ± 1,1 points (p < 0,05).
It is shown that in this group of patients, a decrease in the quality of life for all major subscales with a certain level of
physical deficits on Karnovsky’s scale correlated with indicators of physical functioning and role-emotional functioning
scale MOS SF-36 (r = 0,61 and r = 0,59 respectively). Introduction of modern neuronavigation technologies allows
improve the quality of life of senior patients with glioblastomas of hemicerebrums but does not affect the survival in the
postoperative period.
Целью исследования была оценка динамики качества жизни у пациентов пожилого возраста, прооперированных по поводу глиобластомы
полушарий головного мозга. Показано, что у данной группы цациентов происходит снижение качества жизни по всем основным субшкалам. При этом уровень физического дефицита определенного по шкале Карновского коррелирует с показателями физического функционирования и ролевого эмоционального функционирования шкалы MOS SF-36 (r = 0,61 and r = 0,59 соответственно). Внедрение современных нейронавигационных технологий позволяет
улучшить качество жизни пожилых пациентов с глиобластомами гемицеребра, но не влияет на выживаемость в
послеоперационный период.
