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

Nguyen LT, Touch S, Nehme-Schuster H, Antoni D, Eav S, Clavier JB, Bauer N, Vigneron C, Schott R, Kehrli P, Noël G - Cancers (Basel) (2013)

Bottom Line: 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.However, relevant prognostic factors are needed to optimize treatment proposals.

View Article: PubMed Central - PubMed

Affiliation: Neurology Department, CHU Hautepierre, rue Molière, Strasbourg 67000, France. gnoel@strasbourg.unicancer.fr.

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.

No MeSH data available.


Related in: MedlinePlus

Overall survival curves of patients according to Karnofsky performance score (KPS).
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License
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cancers-05-01177-f002: Overall survival curves of patients according to Karnofsky performance score (KPS).

Mentions: In the univariate analyses, the prognostic factors of OS were KPS (<70 versus ≥70; 4.3 versus 10.3 months; p = 0.0001), concomitant chemotherapy (4 versus 9.8 months; p = 0.0001), and the number of adjuvant TMZ cycles (1–3 cycles versus > 3 cycles, none; p = 0.0001). Patient age, gender, the interval between surgery and radiotherapy, surgery extension, radiotherapy schedule, the MGMT status, and the Charlson score were not prognostic factors. In a multivariable analysis, longer overall survival was only associated with KPS (Figure 2).


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

Nguyen LT, Touch S, Nehme-Schuster H, Antoni D, Eav S, Clavier JB, Bauer N, Vigneron C, Schott R, Kehrli P, Noël G - Cancers (Basel) (2013)

Overall survival curves of patients according to Karnofsky performance score (KPS).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3795385&req=5

cancers-05-01177-f002: Overall survival curves of patients according to Karnofsky performance score (KPS).
Mentions: In the univariate analyses, the prognostic factors of OS were KPS (<70 versus ≥70; 4.3 versus 10.3 months; p = 0.0001), concomitant chemotherapy (4 versus 9.8 months; p = 0.0001), and the number of adjuvant TMZ cycles (1–3 cycles versus > 3 cycles, none; p = 0.0001). Patient age, gender, the interval between surgery and radiotherapy, surgery extension, radiotherapy schedule, the MGMT status, and the Charlson score were not prognostic factors. In a multivariable analysis, longer overall survival was only associated with KPS (Figure 2).

Bottom Line: 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.However, relevant prognostic factors are needed to optimize treatment proposals.

View Article: PubMed Central - PubMed

Affiliation: Neurology Department, CHU Hautepierre, rue Molière, Strasbourg 67000, France. gnoel@strasbourg.unicancer.fr.

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.

No MeSH data available.


Related in: MedlinePlus