Patterns of care and outcomes in elderly patients with glioblastoma in Sao Paulo, Brazil: a retrospective study.
OBJECTIVE
To analyze how elderly patients with glioblastoma are managed in Brazil.


METHODS
We identified 30 patients aged ≥ 65 years treated between 2003 and 2011 at Albert Einstein Hospital in Sao Paulo. We retrospectively reviewed medical records to obtain data on clinical variables, treatment and outcomes. Overall survival (OS) was evaluated using Kaplan-Meier methods and compared using a Wilcoxon log-rank test.


RESULTS
The median age was 73 years. The majority of patients (73.2%) underwent surgical intervention. Following surgery, 80% received radiotherapy (RT), and of those, 79.2% were treated with concurrent temozolomide (TMZ). The median progression free survival and OS were 5 and 10.6 months, respectively. Patients with a KPS ≥ 70 had a median OS of 16.2 months, compared to 6.4 months for those with a KPS <70 (p=0.032). For those patients in whom biopsy only was performed, the median OS was 5.3 months, as compared to 7.8 months for those who underwent partial resection and 18.6 months for those treated with gross total resection (p=0.021). A longer survival was found among patients who received RT versus those who did not (11 months vs. 1 month, p=0.003), as well as for those treated with chemoradiation (13.6 months vs. 6.4 months, p<0.0001).


CONCLUSIONS
This study brings new information about the management of elderly patients with glioblastoma in Brazil. Our data may suggest that elderly patients who undergo cytoreductive surgery and adjuvant RT with concurrent TMZ can do better than those with less aggressive treatment.
Department of Clinical Oncology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. Electronic address: luciolapontes@yahoo.com.br.
Luciola de Barros
Lde B
Pontes
Department of Clinical Oncology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Luiz Victor Maia
LV
Loureiro
Department of Clinical Oncology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Ludmila O
LO
Koch
Department of Geriatrics Oncology, Hospital Israelita Albert Einstein and Universidade de Sao Paulo (USP/ICESP), Sao Paulo, Brazil.
Theodora
T
Karnakis
Department of Clinical Oncology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Rafael Aliosha Kaliks
RA
Guendelmann
Department of Radiation Oncology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Eduardo
E
Weltman
Department of Neuro-oncology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Suzana Maria Fleury
SM
Malheiros
D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000628:therapy*; D001938:Brazil / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
Elderly; Glioblastoma; Oncogeriatrics; Radiotherapy; Surgery