Glioblastoma multiforme in the elderly: a therapeutic challenge.
BACKGROUND
Elderly patients with glioblastoma multiforme (GBM) are frequently excluded from cancer therapy trials, treated suboptimally or not treated at all. The average survival in elderly patients is 4-8 months. The goal of the present study was to evaluate the efficacy of different treatment options in terms of survival in an elderly population affected with GBM.


METHODS
About 34 Patients with primary supratentorial GBM aged 65 or higher were included in this study. All patients underwent craniotomy and tumor mass resection. After surgery they received radiation therapy, chemotherapy and radioimmunotherapy in different combinations.


RESULTS
Overall median survival was 10.5 months with one patient still alive at 35 months. Survival was longer for patients who underwent total resection instead of partial (13 months vs 4 months, P=0.006). If total en-bloc resection was used a further survival advantage was obtained (16 months for en-bloc resection, 9 months for inside-out resection, P=0.008). Where a second surgical intervention was performed median survival was 21 months (P=0.05). Survival according to adjuvant therapy has been 21 months (radiotherapy, chemotherapy, radioimmunotheraphy), 18 months (radiotherapy, chemotherapy) and 7 months (radiotherapy) (P=0.0001).


CONCLUSIONS
We think that single prognostic factor such as age should be not a reason for undertreatment.
Mangiola
A
A
Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
Maira
G
G
De Bonis
P
P
Porso
M
M
Pettorini
B
B
Sabatino
G
G
Anile
C
C
D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures; D011379:Prognosis; D016499:Radioimmunotherapy; D015173:Supratentorial Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D013534:Survival; D014057:Tomography, X-Ray Computed