Glioblastoma Multiforme in the over 70's: "To treat or not to treat with radiotherapy?"
Age Distribution
Age Factors
Aged
Aged, 80 and over
Brain Neoplasms
/ radiotherapy
Clinical Decision-Making
Female
Glioblastoma
/ radiotherapy
Humans
Male
Palliative Care
Practice Guidelines as Topic
Retrospective Studies
Severity of Illness Index
Survival Analysis
Time-to-Treatment
Treatment Outcome
Glioblastoma
Temozolomide
age
debulking
performance status
radiotherapy
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
27
03
2019
revised:
16
06
2019
accepted:
19
06
2019
pubmed:
5
7
2019
medline:
15
8
2020
entrez:
5
7
2019
Statut:
ppublish
Résumé
The incidence of Glioblastoma Multiforme (GBM) is increasing among the older population and is associated with poor prognosis. Management guidelines are lacking in this group. The purpose of this study was to analyze survival data and determine predictors of survival in patients aged ≥70 years treated with radiotherapy (RT) and/or Temozolomide. A retrospective analysis of all GBM patients treated at our institution between January 2011 and January 2017 was carried out. One-hundred and four patients were eligible. Median age was 73.8 years (70-87). Thirty-three patients received radical RT and 71 palliative RT. Overall median survival (MS) was 6 months. The MS was 10.6 months for radical patients and 4.9 months for palliative patients (P < 0.0005). The MS was 6.9 months in patients aged 70-75 years and 5.2 months in those aged 76-80 years (P = 0.004). The debulked group had a statistically significantly longer survival (8.0 months) than the biopsy only group (4.9 months). Biopsy only (hazard ratio [HR] 2.4), ECOG performance status 3 vs 0 (HR 6.4), and increasing age (HR 1.06) were associated with statistically significant shorter survival after adjustment for the effects of concurrent chemo, delay in starting RT, and RT dose. The MS for radical patients was favorable and approaching current literature for the under 70 age group. Radical treatment should be considered for good performance patients aged 70-75 years. Increasing age was associated with shorter MS in patients aged ≥76 years. Debulking and good performance status were associated with improved survival.
Sections du résumé
BACKGROUND
The incidence of Glioblastoma Multiforme (GBM) is increasing among the older population and is associated with poor prognosis. Management guidelines are lacking in this group. The purpose of this study was to analyze survival data and determine predictors of survival in patients aged ≥70 years treated with radiotherapy (RT) and/or Temozolomide.
MATERIALS AND METHODS
A retrospective analysis of all GBM patients treated at our institution between January 2011 and January 2017 was carried out.
RESULTS
One-hundred and four patients were eligible. Median age was 73.8 years (70-87). Thirty-three patients received radical RT and 71 palliative RT. Overall median survival (MS) was 6 months. The MS was 10.6 months for radical patients and 4.9 months for palliative patients (P < 0.0005). The MS was 6.9 months in patients aged 70-75 years and 5.2 months in those aged 76-80 years (P = 0.004). The debulked group had a statistically significantly longer survival (8.0 months) than the biopsy only group (4.9 months). Biopsy only (hazard ratio [HR] 2.4), ECOG performance status 3 vs 0 (HR 6.4), and increasing age (HR 1.06) were associated with statistically significant shorter survival after adjustment for the effects of concurrent chemo, delay in starting RT, and RT dose.
CONCLUSION
The MS for radical patients was favorable and approaching current literature for the under 70 age group. Radical treatment should be considered for good performance patients aged 70-75 years. Increasing age was associated with shorter MS in patients aged ≥76 years. Debulking and good performance status were associated with improved survival.
Identifiants
pubmed: 31270955
doi: 10.1002/cam4.2398
pmc: PMC6712461
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4669-4677Informations de copyright
© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
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