Brain Tumor Res Treat.  2014 Oct;2(2):69-75. 10.14791/btrt.2014.2.2.69.

The Clinico-Oncologic Outcomes of Elderly Patients with Glioblastoma after Surgical Resection Followed by Concomitant Chemo-Radiotherapy

• Park HK
• Koh YC
• Song SW

• KMID: 2134274
• DOI: http://doi.org/10.14791/btrt.2014.2.2.69

Abstract

BACKGROUND
There have been controversies in the treatment of elderly patients with glioblastoma. We introduce the outcome of the treatment of elderly patients with glioblastoma comparing with younger patients.
METHODS
The author's hospital database was used to identify patients with histologically confirmed glioblastoma after surgery between January 2006 and December 2013. Forty-eight patients (control group) were under age 65 and 16 patients (elderly group) were aged 65 years or over at the time of surgery.
RESULTS
The median age of the elderly group was 71 years and control group was 50 years. Mean number of medical comorbidities was 1.8 in the elderly group vs. 0.5 in the control group. The median progression free survival (PFS) was 5.6 months and the median overall survival (OS) was 19.9 months in all patients. The elderly group had a median PFS of 4.2 months vs. 8 months for the control group (log-rank test, p=0.762). Median OS was 8.2 months in the elderly group vs. 20.9 months in the control group (log-rank test, p=0.457). Major complications occurred in 5 cases (7.8%) for all patients. The ratio of completion of concomitant chemo-radiotherapy (CCRT) was 81.3% and was the same between the two groups. In multivariable analysis, extent of resection (p=0.034) and completion of CCRT (p=0.023) were statistically significant, independent prognostic factors only for PFS in all patients by Cox proportional hazards model. Age was not an independent prognostic factor. As for OS, there was no significant factor.
CONCLUSION
Surgical resection and CCRT were well tolerated in elderly patients with glioblastoma, and maximal safe resection followed by timely CCRT could improve clinic-oncologic outcomes.

Keyword

Elderly, outcome; Glioblastoma; Prognosis; Concomitant chemoradiotherapy

MeSH Terms

Aged*
Chemoradiotherapy
Comorbidity
Disease-Free Survival
Glioblastoma*
Humans
Prognosis
Proportional Hazards Models

Figure

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  Fig. 1 Comparison of progression free survival.

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  Fig. 2 Comparison of overall survival.

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