title: Short-course radiotherapy in elderly patients with glioblastoma: feasibility and efficacy of results from a single centre.
abstract: BACKGROUND
  The incidence of glioblastoma (GBM) in the elderly population is currently increasing, with a peak seen between 65 and 84 years. The optimal treatment in terms of both efficacy and quality of life still remains a relevant and debated issue today. The purpose of our study was to evaluate the feasibility of short-course hypofractionated accelerated radiotherapy (HART) in GBM patients aged over 70 years and with a good Karnofsky performance score (KPS).
  
  
  METHODS
  A review of medical records at the "Istituto Neurologico C. Besta" was undertaken; patients aged ≥ 70 years who had undergone adjuvant HART for GBM between January 2000 and January 2004 were included in the study. HART was administered to a total dose of 45 Gy, 2.5 Gy/fraction, in three daily fractions for three consecutive days/cycle fractions each, delivered in two cycles (split 15 days).
  
  
  RESULTS
  A total of 33 patients were evaluable for the current analysis. Median follow-up was 10 months. According to CTCAE (version 3.0) criteria, none of the patients developed radiation-induced neurological status deterioration or necrosis. KPS evaluation after HART was found to be stable in 73 % of patients, improved in 24 %, and worse in 3 %. The median overall survival time of the entire study population was 8 months (range 2-24).
  
  
  CONCLUSIONS
  Our findings suggest that a hypofractionated accelerated schedule can be a safe and effective option in the treatment of GBM in the elderly.
authors.affiliation: Departement of Neurosurgery, Division of Radiotherapy, Neurological Carlo Besta Institute Foundation, via Celoria 11, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fariselli
authors.forename: V
authors.initials: V
authors.lastname: Pinzi
authors.forename: I
authors.initials: I
authors.lastname: Milanesi
authors.forename: A
authors.initials: A
authors.lastname: Silvani
authors.forename: M
authors.initials: M
authors.lastname: Marchetti
authors.forename: M
authors.initials: M
authors.lastname: Farinotti
authors.forename: A
authors.initials: A
authors.lastname: Salmaggi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000532:radiotherapy*; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008279:Magnetic Resonance Imaging; D008297:Male; D011788:Quality of Life / Q000523:psychology; D020266:Radiotherapy, Conformal; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome