Short course of radiation therapy in elderly patients with glioblastoma multiforme

Idbaïh, Ahmed; Taillibert, Sophie; Simon, J.-M.; Psimaras, Dimitri; Schneble, Hans Martin; Lopez, S.; Lang, Philippe; Toubiana, T.; Feuvret, L.; Delattre, Jean‐Yves; Jj, Mazeron

doi:10.1016/j.canrad.2008.05.007

Cited by 24 publications

(12 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Here RT was delivered in a safe 3-week schedule for patients more than 80 years old (median 82, range 80-91) with a resulting median OS of 7.5 months. In 2008, Idbaih et al reported favourable results with the same short regimen without CHT (Table 3) [17]. We decided to analyse an older population, so called "very elderly" patients, to fill a gap in the literature caused by inconsistency in the definition of "elderly" ( Table 3).…”

Section: Discussionmentioning

confidence: 99%

Role of irradiation for patients over 80 years old with glioblastoma: a retrospective cohort study

Bracci¹,

Laigle‐Donadey

Hitchcock

et al. 2016

J Neurooncol

View full text Add to dashboard Cite

To assess efficacy and safety of hypofractionated radiation therapy (HRT) in patients over 80 years old with newly diagnosed glioblastoma (GBM). Between June 2009 and September 2015, patients in this population with a recommendation for radiation therapy from a multidisciplinary tumor board, and a Karnofsky performance status (KPS) ≥60 as assessed by a radiation oncologist, who received HRT (40 Gy/15 fractions) ± concomitant and adjuvant temozolomide (TMZ) were retrospectively analyzed. A total of 21 patients fulfilled the criteria for eligibility. Median KPS was 80 (60-90). After a median follow-up of 5.8 months (IQR 3.7-13.1 months), median overall survival (OS) was 7.5 months (95 % CI 4.5-19.1) and the 1-year and 2-year OS were 39.5 % (95 % CI 21.9-71.2 %) and 6.6 % (95 % CI 1.0- 43.3 %), respectively. Median progression-free survival (PFS) was 5.8 months (95 % CI 3.9-7.7 months), 1-year and 2-year PFS were 15.2 % (95 % CI 4.4-52.4) and 0 %, respectively. Overall, 16 (76.2 %) patients presented a recurrence. Overall seven patients (33.3 %) needed to be hospitalized during treatment. On univariate analysis, hospitalization was the only variable that correlated with less favourable outcome in terms of both OS (12.2 months versus 3.8 months, p < 0.010) and PFS (5.8 months versus 3.4 months, p = 0.002). Our study suggests that HRT is feasible with acceptable tolerance among "very elderly" patients affected by GBM. Patients 80 and older should be considered for management based on RT.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of irradiation for patients over 80 years old with glioblastoma: a retrospective cohort study

Bracci¹,

Laigle‐Donadey

Hitchcock

et al. 2016

J Neurooncol

View full text Add to dashboard Cite

show abstract

“…In addition to its associated morbidity, conventional prolonged courses of radiotherapy delivering 60 Gy over a 6-week period might seem too long and inconvenient for some aged patients with short survival expectancy. Hence, short-term radiotherapy has been suggested as an effective and safe alternative for this selected population [60][61][62]. This issue was specifically addressed in another randomized trial [63].…”

Section: Radiation Therapymentioning

confidence: 99%

Management of Elderly Patients With Gliomas

Pérez-Larraya

Delattre

2014

The Oncologist

View full text Add to dashboard Cite

The current progressive aging of the population is resulting in a continuous increase in the incidence of gliomas in elderly people, especially the most frequent subtype, glioblastoma (GBM). This sociohealth shift, known as the "silver tsunami," has prompted the neuro-oncology community to investigate the role of specific antitumor treatments, such as surgery, radiotherapy, chemotherapy, and other targeted therapies, for these traditionally undertreated patients. Advanced age, a widely recognized poor prognostic factor in both low-grade glioma (LGG) and high-grade glioma patients, should no longer be the sole reason for excluding such older patients from receiving etiologic treatments. Far from it, results from recent prospective trials conducted on elderly patients with GBM demonstrate that active management of these patients can have a positive impact on survival without impairing either cognition or quality of life. Although prospective studies specifically addressing the management of grade 2 and 3 gliomas are lacking and thus needed, the aforementioned tendency toward acknowledging a therapeutic benefit for GBM patients might also apply to the treatment of patients with LGG and anaplastic gliomas. Inorder tooptimize such etiologic treatment in conjunction with symptomatic management, neuro-oncology multidisciplinary boards must individually consider important features such as resectability of the tumor, functional and cognitive status, associated comorbidities, and social support.

show abstract

“…Modifications of radiotherapy aiming to improve survival or the quality of life of the patients have been proposed, e.g. hypofractionation, reduction of the dose or adaptation of the field size [24][25][26][27][28][29][30][31]. We analyzed whether it is possible to use the findings in MRIs during (chemo)radiotherapy as a predictor for the clinical course and for early prognostic stratification of patients.…”

Section: Discussionmentioning

confidence: 99%