426P - Glioblastoma in elderly patients: survival outcome

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Geriatric Oncology
Central Nervous System Malignancies
Presenter Mª Angeles Vaz
Citation Annals of Oncology (2014) 25 (suppl_4): iv137-iv145. 10.1093/annonc/mdu330
Authors M.A. Vaz1, J. Del Toro2, J.A.G. Cerco3, L.L. Urzaiz4, A. Carrato2, A. Gomez2, H. Pian5, M.D.A. De Pedro3
  • 1Medical Oncology, Ramon y Cajal University Hospital, 0034 - Madrid/ES
  • 2Medical Oncology, Ramon y Cajal University Hospital, Madrid/ES
  • 3Neurosurgery, Ramon y Cajal University Hospital, 0034 - Madrid/ES
  • 4Neurosurgery, Ramon y Cajal University Hospital, Madrid/ES
  • 5Pathology, Ramon y Cajal University Hospital, Madrid/ES

Abstract

Aim

The management of glioblastoma (GB) in elderly patients is not well established. The incidence is higher in this population and is expected to increase over the next decades in relation with an aging population. Until recently, these patients have been excluded from randomized trials. The effectiveness of the conventional active treatment has been controversial, since benefit was attenuated in older and there are concerns about mental deterioration.

Methods

The authors retrospectively reviewed 53 patients at a single institution (2005-2013). Patients were 70 years or older with histologically confirmed GB.

Results

Median age was 75 years (y) (range 70-88), and nearly 60% of population was between 70-80 y. Gender: 56% men. Location: frontal lobe (37.7%), temporal (32%). Most had any morbidity (89%), mainly arterial hypertension (55%), diabetes (13%). Partial resection was planned in 49% of cases, and complete resection in 45%. After surgery 71% received radiotherapy(RT) (45% 60 Gy and 26% 30Gy). Nearly 40% were treated with concomitant and adyuvant Temozolamide (Stupp regimen). The median number of cycles was 4.43 (range 1-14). With regard to toxicity only 3 patients reached grade 4 (neutropenia and trombopenia). Median survival for the whole cohort was 7,36 m (95% CI 4,8-9,8). Median progression free survival (PFS) was 5.9 m (3-8.7m). Treatment with Stupp regimen was associated with longer overall survival (11.16 months vs 4.1 months; p= 0.008). Median overall survival in the cohort of patients who received or not RT was 8.3 months vs 1.5 months respectively (p = 0.046). Differences were found between the subgroup treated with 30 Gy vs 60 Gy in terms of overall survival in favor to the second one, but didńt reach statistical significance (6,3 vs 11,1; p = 0.143). Only 10% of patients could receive a second line treatment and median survival was 4.8 months.

Conclusions

Elderly patients diagnosed with GB had worst prognosis. In our experience, in patients with newly diagnosed glioblastoma over the age of 70, more intensive treatment was associated with prolonged OS, and results are close to those obtained from younger patients. Nevertheless these are retrospective data and a selection bias may be the explanation. Further randomized trial should be conducted to investigate this topic.

Disclosure

All authors have declared no conflicts of interest.