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Glioblastoma in elderly patients: Safety and efficacy of adjuvant radiotherapy with concomitant temozolomide
Archives of Gerontology and Geriatrics, 07/31/09

Fiorica F et al. - In a trial to evaluate the impact of radiotherapy plus concomitant and adjuvant temozolomide (TMZ) in terms of feasibility and activity in elderly pts with glioblastoma, it was reported that the adjuvant chemoradiotherapy was well tolerated with an acceptable rate of toxicity, and pts with a good performance status had significantly better survival.

Methods

42 consecutive pts with glioblastoma (27 men, 15 women) aged ≥65 yrs, received radiotherapy plus concomitant and adjuvant TMZ.
19 pts (45.2%) had a Karnofsky index ≥80.
36 pts (85.8%) underwent complete or subtotal resection, while 6 pts (14.2%) were only biopsied.
All pts received adjuvant radiotherapy within 4 wks from surgery.
22 pts (54.8%) underwent adjuvant TMZ.

Results

Early discontinuation of concomitant TMZ program due to toxicity was observed in 8 pts.
Considered variables were: age, Karnofsky index, surgery vs no surgery, radiation dose, and chemotherapy.
At median follow-up of 10.2 mos, the 6- and 12-mo overall survival rates were 81.9% and 27.8%, respectively.
There was significantly better survival for pts with a performance status according to Karnofsky >80.
Actuarial progression-free survival at 6- and 12-mos was 46.4% and 9.8%, respectively.
Globally, treatment was well tolerated with no treatment-related toxicity in 69% of pts.

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