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. 2013 Sep 24;5(3):1177-98.
doi: 10.3390/cancers5031177.

Outcomes in newly diagnosed elderly glioblastoma patients after concomitant temozolomide administration and hypofractionated radiotherapy

Ludovic T Nguyen  1 , Socheat Touch, Hélène Nehme-Schuster, Delphine Antoni, Sokha Eav, Jean-Baptiste Clavier, Nicolas Bauer, Céline Vigneron, Roland Schott, Pierre Kehrli, Georges Noël
Affiliations

Outcomes in newly diagnosed elderly glioblastoma patients after concomitant temozolomide administration and hypofractionated radiotherapy

Ludovic T Nguyen et al. Cancers (Basel). .

Abstract

This study aimed to analyze the treatment and outcomes of older glioblastoma patients. Forty-four patients older than 70 years of age were referred to the Paul Strauss Center for chemotherapy and radiotherapy. The median age was 75.5 years old (range: 70-84), and the patients included 18 females and 26 males. The median Karnofsky index (KI) was 70%. The Charlson indices varied from 4 to 6. All of the patients underwent surgery. O6-methylguanine-DNA methyltransferase (MGMT) methylation status was determined in 25 patients. All of the patients received radiation therapy. Thirty-eight patients adhered to a hypofractionated radiation therapy schedule and six patients to a normofractionated schedule. Neoadjuvant, concomitant and adjuvant chemotherapy regimens were administered to 12, 35 and 20 patients, respectively. At the time of this analysis, 41 patients had died. The median time to relapse was 6.7 months. Twenty-nine patients relapsed, and 10 patients received chemotherapy upon relapse. The median overall survival (OS) was 7.2 months and the one- and two-year OS rates were 32% and 12%, respectively. In a multivariate analysis, only the Karnofsky index was a prognostic factor. Hypofractionated radiotherapy and chemotherapy with temozolomide are feasible and acceptably tolerated in older patients. However, relevant prognostic factors are needed to optimize treatment proposals.

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Figures

Figure 1
Figure 1
Overall survival for all patients.
Figure 2
Figure 2
Overall survival curves of patients according to Karnofsky performance score (KPS).
Figure 3
Figure 3
Overall survival of patients according to RPA score (p < 0.001). (GTR: gross total resection; KPS: Karnofsky performance score; PR: partial resection).
Figure 4
Figure 4
Overall survival curves of patients with methylated or unmethylated MGMT.
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