title: Treatment outcomes in glioblastoma patients aged 76 years or older: a multicenter retrospective cohort study.
abstract: Age is one of the most important prognostic factors in glioblastoma patients, but no standard treatment has been established for elderly patients with this condition. We therefore conducted a retrospective cohort study to evaluate treatment regimens and outcomes in elderly glioblastoma patients. The study population consisted of 79 glioblastoma patients aged ≥ 76 years (median age 78.0 years; 34 men and 45 women). The median preoperative Karnofsky performance status (KPS) score was 60. Surgical procedures were classified as biopsy (31 patients, 39.2 %), <95 % resection of the tumor (21 patients, 26.9 %), and ≥ 95 % resection of the tumor (26 patients, 33.3 %). Sixty-seven patients (81.0 %) received radiotherapy and 45 patients (57.0 %) received chemotherapy. The median overall progression-free survival time was 6.8 months, and the median overall survival time was 9.8 months. Patients aged ≥ 78 years were significantly less likely to receive radiotherapy (p = 0.004). Patients with a postoperative KPS score of ≥ 60 were significantly more likely to receive maintenance chemotherapy (p = 0.008). Multivariate analyses identified two independent prognostic factors: postoperative KPS score ≥ 60 (hazard ratio [HR] = 0.531, 95 % confidence interval [CI] 0.315-0.894, p = 0.017) and temozolomide therapy (HR = 0.442, 95 % CI 0.25-0.784, p < 0.001).The findings of this study suggest that postoperative KPS score is an important prognostic factor for glioblastoma patients aged ≥ 76 years, and that these patients may benefit from temozolomide therapy.
authors.affiliation: Department of Neurosurgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-chou, Chuo-ku, Niigata, 951-8566, Japan, uzuka@niigata-cc.jp.
authors.forename: Takeo
authors.initials: T
authors.lastname: Uzuka
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Asano
authors.forename: Toshio
authors.initials: T
authors.lastname: Sasajima
authors.forename: Kaori
authors.initials: K
authors.lastname: Sakurada
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kumabe
authors.forename: Takaaki
authors.initials: T
authors.lastname: Beppu
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ichikawa
authors.forename: Chifumi
authors.initials: C
authors.lastname: Kitanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aoki
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Saito
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Ogasawara
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
authors.forename: Kazuo
authors.initials: K
authors.lastname: Mizoi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohkuma
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Fujii
authors.forename: Takamasa
authors.initials: T
authors.lastname: Kayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents