Impact of age and co-morbidities in patients with newly diagnosed glioblastoma: a pooled data analysis of three prospective mono-institutional phase II studies.
To analyse the impact of age and co-morbidities on compliance and outcomes in GBM patients enrolled in three prospective phase II trials. GBM patients (≥ 18 years) were treated with radiotherapy (60 Gy) or enrolled in a Fractionated Stereotactic Conformal-Radiotherapy Phase II trial (69.4 Gy). Concomitant and adjuvant chemotherapy with Temozolomide (TMZ) was administered. Charlson Index Co-morbidity (CCI) was used to assess co-morbidity. Toxicity was evaluated according to RTOG score. Survival analysis was performed by the Kaplan-Maier. Influence of age and co-morbidity was evaluated using log-rank test. From 2001 to 2008, 146 patients were enrolled: 56 (38.4 %) aged over 65 and 90 under 65. CCI ≥ 1 was observed in 41 % of elderly and 22 % of young group. Patients' compliance was 97.9 % for radio-chemotherapy. Acute toxicity was mild with no difference between the groups. Global median progression-free survival (PFS) and overall survival (OS) were 12 and 18 months, respectively. Age, surgery and radiation dose correlated with survival (p = 0.01, p = 0.04 and p = 0.03). CCI ≤ 2 did not show any influence on OS. Our data show that elderly with a good performance status and few co-morbidity may be treated as younger patients; moreover, age confirms a negative impact on survival while CCI ≤ 2 did not correlated with OS.
Department of Radiation Oncology, Catholic University of Sacred Heart, Largo A. Gemelli, 00135, Rome, Italy.
Mario
M
Balducci
Alba
A
Fiorentino
Pasquale
P
De Bonis
Silvia
S
Chiesa
Stefania
S
Manfrida
Giuseppe Roberto
GR
D'Agostino
Giovanna
G
Mantini
Vincenzo
V
Frascino
Gian Carlo
GC
Mattiucci
Berardino
B
De Bari
Annunziato
A
Mangiola
Francesco
F
Miccichè
Maria Antonietta
MA
Gambacorta
Gabriella
G
Colicchio
Alessio Giuseppe
AG
Morganti
Carmelo
C
Anile
Vincenzo
V
Valentini
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000401:mortality* / Q000628:therapy*; D003131:Combined Modality Therapy; D015897:Comorbidity; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery; D011878:Radiotherapy; D000077204:Temozolomide; D055815:Young Adult
D000970:Antineoplastic Agents; D003606:Dacarbazine; D000077204:Temozolomide