Treatment outcomes in glioblastoma patients aged 76 years or older: a multicenter retrospective cohort study

Abstract

Age is one of the most important prognostic factors in glioblastoma patients, but no standard treatment has been established for elderly patients with this condition. We therefore conducted a retrospective cohort study to evaluate treatment regimens and outcomes in elderly glioblastoma patients. The study population consisted of 79 glioblastoma patients aged ≥ 76 years (median age 78.0 years; 34 men and 45 women). The median preoperative Karnofsky performance status (KPS) score was 60. Surgical procedures were classified as biopsy (31 patients, 39.2 %), <95 % resection of the tumor (21 patients, 26.9 %), and ≥ 95 % resection of the tumor (26 patients, 33.3 %). Sixty-seven patients (81.0 %) received radiotherapy and 45 patients (57.0 %) received chemotherapy. The median overall progression-free survival time was 6.8 months, and the median overall survival time was 9.8 months. Patients aged ≥ 78 years were significantly less likely to receive radiotherapy (p = 0.004). Patients with a postoperative KPS score of ≥ 60 were significantly more likely to receive maintenance chemotherapy (p = 0.008). Multivariate analyses identified two independent prognostic factors: postoperative KPS score ≥ 60 (hazard ratio [HR] = 0.531, 95 % confidence interval [CI] 0.315-0.894, p = 0.017) and temozolomide therapy (HR = 0.442, 95 % CI 0.25-0.784, p < 0.001).The findings of this study suggest that postoperative KPS score is an important prognostic factor for glioblastoma patients aged ≥ 76 years, and that these patients may benefit from temozolomide therapy.

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

“…Piccirilli et al treated 22 patients over 80 years old (median age 83.6) with surgery plus RT and/or CHT and reached a median OS of 13.7 months [18]. A recent Japanese multicentre retrospective cohort study analysed the treatment outcomes in 79 patients age 76 and older (median age 78 years) with histologically confirmed GBM [19]. Median PFS and OS were 6.8 and 9.8 months, respectively.…”

“…Uzuka et al found that the use of concomitant and/or adjuvant TMZ and postoperative KPS were independent predictors of survival on multivariate analyses in patients 76 or older (median 78 years) [19]. Minniti et al treated 71 patient ≥70 years old with hypofractionated 3-week RT with concomitant and adjuvant TMZ in a phase II study and reported a median OS of 12.4 months [21].…”

Treatment of Malignant Gliomas in Elderly Patients: A Concise Overview of the Literature

“…Uzuka et al [23] analyzed in a multicentric retrospective study the treatment outcome in elderly patients (see Table 1). The study population consisted of 79 glioblastoma patients aged >76 years.…”

Radiation therapy for older adults with glioblastoma: radical treatment, palliative treatment, or no treatment at all?

“…Using a similar fractionation, a median overall survival of 9-11 months has been reported in several retrospective series [31,33,35]. For patients treated with chemoradiotherapy, MGMT promoter methylation is a strong favorable prognostic factor for survival (Table 2) [20,32,37]. In a series of 58 patients aged C65 years who received standard chemoradiation for newly diagnosed GBM, the median overall survival was 13.7 months for patients with MGMT unmethylated tumors but was not reached for patients with methylated tumors (p = 0.05), and the median progression-free survival was 9.5 and 22.9 months, respectively (p = 0.01) [20].…”

“…The use of standard RT in combination with TMZ as an initial treatment for older patients with GBM has been RT radiotherapy, PFS progression-free survival, CHT chemotherapy, TMZ temozolomide, MGMT O6-methylguanine-DNA methyltransferase, NA not addressed a Series include anaplastic astrocytomas and glioblastomas J Neurooncol evaluated in a few prospective (Table 1) [10,18,21] and retrospective studies [19,[31][32][33][34][35][36][37]. In a prospective series of 32 patients aged C70 years treated at the University of Rome Sapienza, Sant'Andrea Hospital, the median overall survival time and 1-year survival rate were 10.6 months and 37 %, respectively, and the median and 1-year progression-free survivals were 7 months and 16 %, respectively [18].…”