Note (General)博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨
Purpose: To investigate the impact of early and continuous postoperative inpatient rehabilitation during chemoradiotherapy on functional outcomes and overall survival (OS) in patients with glioblastoma (GBM), particularly in different age groups.Methods: This retrospective cohort study at a university hospital (2011–2016) included 75 of 119 consecutive patients newly diagnosed with GBM who underwent standardized treatment and postoperative rehabilitation. Patients were divided into older (≥ 65 years, n = 45) and younger (< 65 years, n = 30) groups, engaging in a 50-day rehabilitation program. We assessed rehabilitation progress, Barthel Index (BI), Brunnstrom Recovery Stage (BRS), adverse events, and OS. BI at discharge and survival were analyzed using multivariate and Cox regression models, respectively.Results: The mean age was 72.5 ± 6.3 and 52.4 ± 7.8 years in the older and younger groups, respectively. Both groups demonstrated significant improvements in BI and BRS. Despite more adverse events in the older group, no significant difference existed in median OS (older group: 18.7 months vs. younger group: 18.3 months, p = 0.87). Early walking training, reduced fatigue during chemoradiotherapy, and high Karnofsky Performance Status at admission significantly impacted the BI at discharge. Cox regression analysis identified the BI at discharge as a significant predictor of survival (hazard ratio [HR] 0.98, 95% confidence interval [CI] 0.97–0.99, p = 0.008).Conclusion: Integrated rehabilitation improves functional outcomes, and enhanced ADL at discharge is associated with improved survival outcomes in patients with GBM, regardless of age. This highlights the need for personalized rehabilitation in treatment protocols. Further prospective studies are warranted to confirm these findings.
Keisuke Natsume, Akira Yoshida, Harutoshi Sakakima, Hajime Yonezawa, Kentaro Kawamura, Shintaro Akihiro, Ryosuke Hanaya, Megumi ShimodozonoAge-independent benefits of postoperative rehabilitation during chemoradiotherapy on functional outcomes and survival in patients with glioblastomaJ Neurooncol 170, 129–137 (2024)https://doi.org/10.1007/s11060-024-04785-1
The version of record of this article, first published in Journal of Neuro-Oncology, is available online at Publisher’s website: https://doi.org/10.1007/s11060-024-04785-1
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2025-02-07T22:15:51+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション