425P - The role of temozolomide and radiation therapy in elderly patients with glioblastoma: A monoinstitutional retrospective study

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Geriatric Oncology
Central Nervous System Malignancies
Surgery and/or Radiotherapy of Cancer
Presenter Patrizia Farina
Citation Annals of Oncology (2014) 25 (suppl_4): iv137-iv145. 10.1093/annonc/mdu330
Authors P. Farina1, G. Lombardi1, L. Bellu2, P. Fiduccia3, F. Berti4, F. Navarria5, A. Della Puppa6, V. Zagonel1
  • 1Medical Oncology 1 Unit, Veneto Institute of Oncology, 35128 - Padua/IT
  • 2Medical Oncology 1, Veneto Institute of Oncology, 35128 - Padua/IT
  • 32clinical Trials And Biostatistics Unit, Veneto Institute of Oncology, 35128 - Padua/IT
  • 4Radiation Therapy Unit, Veneto Institute of Oncology, 35121 - Padova/IT
  • 5Radiation Therapy Unit, Veneto Institute of Oncology, 35121 - Padua/IT
  • 6Neurosurgery Department, Azienda Ospedaliera di Padova, 35128 - Padua/IT



The efficacy of temozolomide(TMZ) plus radiation therapy(RT) in elderly patients(EP) with glioblastoma(GBM) is unclear. We describe our experience of combining RT with concurrent TMZ in EP.


Medical records of patients ≥65 years old with newly GBM, histologically confirmed and treated at Venetian Institute of Oncology – Padua, were reviewed. Concomitant TMZ was 75mg/m2/die. The adjuvant treatment consisted of TMZ 150-200mg/m2/die for six cycles.


We analyzed 67 consecutive patients(PTS), 35 males and 32 females; the average age was 71 (range 65-86); ECOG PS was 0-1 in 37 PTS and 2-3 in 30 PTS; complete surgery was performed in 41 PTS, partial surgery in 24 PTS. MGMT was analyzed in 46 PTS: methylated(met) MGMT in 21 PTS (46%). 36 PTS were treated with RT 40Gy in 15 fractions, 23 PTS with RT 60Gy in 30 fractions, 8 PTS with only TMZ. For all PTS, PFS and OS was 7 and 12.4 ms, respectively. PFS was 7.2 vs 6.7 ms (p = 0.5), OS was 11.9 vs 13.8 ms (p = 0.3), for PTS treated with RT 40Gy and 60Gy, respectively. PFS was 7.2 vs 4.5 ms (p = 0.04), OS was 13 vs 7.3 ms (p < 0.01), for PTS treated with RT + TMZ vs only TMZ, respectively. Among PTS treated with RT + TMZ, 46 were evaluable for MGMT: 21 with metMGMT. OS was 11.7 vs 18.6 (p < 0.01) for unmet and met MGMT, respectively. We had no significant difference in terms of PFS and OS between partial and complete surgery. On multivariate analysis, RT + TMZ treatment (HR 0.2, 95% CI 95% 0.09-0.6) and metMGMT (HR 0.35, 95% CI 0.1-0.7) were independent predictors of longer OS. Regarding toxicity: grade 1-2 haematological toxicity was 19%, 23% and 42%, grade 1-2 asthenia was 25%, 23% and 42% of PTS receiving RT 40Gy + TMZ, RT 60Gy + TMZ and TMZ alone, respectively; nausea/vomiting was 5% and 3% of PTS receiving RT 60 and 40Gy; grade 3-4 haematological toxicity was 6% in PTS receiving RT + TMZ, no severe haematological toxicity and asthenia was reported in PTS receiving TMZ alone.


RT plus TMZ is effective and safe in EP with GBM. RT + TMZ treatment seems more effective than only TMZ. PFS and OS were not statistically different between RT 40Gy or 60Gy. RT + TMZ treatment and met MGMT were independent predictors of longer survival. In contrast, severe haematological toxicity was higher in PTS with RT + TMZ compared to TMZ alone.


All authors have declared no conflicts of interest.