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Radiotherapy with or without temozolomide in elderly patients aged ≥ 70 years with glioblastoma

INTRODUCTION: Although the recommended optimal treatment of glioblastoma multiforme (GBM) is adjuvant chemoradiotherapy, trials in GBM have excluded patients older than 70 years. In this study, we aimed to assess overall survival (OS) and prognostic factors in elderly patients (≥ 70 years) with newl...

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Autores principales: Metcalfe, Evrim, Karaoglanoglu, Ozden, Akyazici, Emine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013689/
https://www.ncbi.nlm.nih.gov/pubmed/27647990
http://dx.doi.org/10.5114/wo.2016.61569
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author Metcalfe, Evrim
Karaoglanoglu, Ozden
Akyazici, Emine
author_facet Metcalfe, Evrim
Karaoglanoglu, Ozden
Akyazici, Emine
author_sort Metcalfe, Evrim
collection PubMed
description INTRODUCTION: Although the recommended optimal treatment of glioblastoma multiforme (GBM) is adjuvant chemoradiotherapy, trials in GBM have excluded patients older than 70 years. In this study, we aimed to assess overall survival (OS) and prognostic factors in elderly patients (≥ 70 years) with newly diagnosed GBM treated with radiotherapy (RT) ± concurrent/adjuvant temozolomide (TMZ). MATERIAL AND METHODS: Inclusion criteria were patients ≥ 70 years, pre-RT Karnofsky performance status (KPS) ≥ 60, and time between diagnosis and start of RT ≤ 2 months. A total of 40 patients aged ≥ 70 years, 12 female and 28 male, treated between January 2004 and December 2012, were evaluated. Median age was 73.5 years (range, 70–83 years). The median RT dose was 60 Gy (range, 30–62 Gy). Twenty-one (52.5%) received concurrent TMZ, and of those 12 (30%) went on to receive adjuvant TMZ. RESULTS: The median OS was 7 months (95% CI: 5.45–8.54). One- and two-year OS for the whole cohort was 38% and 16%, respectively. Sex, type of surgery, tumor size, and RT dose did not significantly affect the OS. Presence of concurrent TMZ (p < 0.005) and presence of adjuvant TMZ (p < 0.001) were associated with longer OS in our cohort. CONCLUSIONS: RT ± TMZ seems to be a well-tolerated treatment in patients ≥ 70 years with GBM. Even though no superiority was found between conventional or hypofractionated RT regimens (p = 0.405), the addition of concurrent and adjuvant TMZ to RT increased the OS in our study.
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spelling pubmed-50136892016-09-19 Radiotherapy with or without temozolomide in elderly patients aged ≥ 70 years with glioblastoma Metcalfe, Evrim Karaoglanoglu, Ozden Akyazici, Emine Contemp Oncol (Pozn) Original Paper INTRODUCTION: Although the recommended optimal treatment of glioblastoma multiforme (GBM) is adjuvant chemoradiotherapy, trials in GBM have excluded patients older than 70 years. In this study, we aimed to assess overall survival (OS) and prognostic factors in elderly patients (≥ 70 years) with newly diagnosed GBM treated with radiotherapy (RT) ± concurrent/adjuvant temozolomide (TMZ). MATERIAL AND METHODS: Inclusion criteria were patients ≥ 70 years, pre-RT Karnofsky performance status (KPS) ≥ 60, and time between diagnosis and start of RT ≤ 2 months. A total of 40 patients aged ≥ 70 years, 12 female and 28 male, treated between January 2004 and December 2012, were evaluated. Median age was 73.5 years (range, 70–83 years). The median RT dose was 60 Gy (range, 30–62 Gy). Twenty-one (52.5%) received concurrent TMZ, and of those 12 (30%) went on to receive adjuvant TMZ. RESULTS: The median OS was 7 months (95% CI: 5.45–8.54). One- and two-year OS for the whole cohort was 38% and 16%, respectively. Sex, type of surgery, tumor size, and RT dose did not significantly affect the OS. Presence of concurrent TMZ (p < 0.005) and presence of adjuvant TMZ (p < 0.001) were associated with longer OS in our cohort. CONCLUSIONS: RT ± TMZ seems to be a well-tolerated treatment in patients ≥ 70 years with GBM. Even though no superiority was found between conventional or hypofractionated RT regimens (p = 0.405), the addition of concurrent and adjuvant TMZ to RT increased the OS in our study. Termedia Publishing House 2016-08-04 2016 /pmc/articles/PMC5013689/ /pubmed/27647990 http://dx.doi.org/10.5114/wo.2016.61569 Text en Copyright: © 2016 Termedia Sp. z o. o. http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Metcalfe, Evrim
Karaoglanoglu, Ozden
Akyazici, Emine
Radiotherapy with or without temozolomide in elderly patients aged ≥ 70 years with glioblastoma
title Radiotherapy with or without temozolomide in elderly patients aged ≥ 70 years with glioblastoma
title_full Radiotherapy with or without temozolomide in elderly patients aged ≥ 70 years with glioblastoma
title_fullStr Radiotherapy with or without temozolomide in elderly patients aged ≥ 70 years with glioblastoma
title_full_unstemmed Radiotherapy with or without temozolomide in elderly patients aged ≥ 70 years with glioblastoma
title_short Radiotherapy with or without temozolomide in elderly patients aged ≥ 70 years with glioblastoma
title_sort radiotherapy with or without temozolomide in elderly patients aged ≥ 70 years with glioblastoma
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013689/
https://www.ncbi.nlm.nih.gov/pubmed/27647990
http://dx.doi.org/10.5114/wo.2016.61569
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