title: Oncological patterns of care and outcomes for 265 elderly patients with newly diagnosed glioblastoma in France.
abstract: The incidence of glioblastoma (GBM) has increased in patients aged 70 years or older, and will continue to grow. Elderly GBM patients have been excluded from most clinical trials; furthermore, optimal care management as well as benefit/risk ratio of GBM treatments are still being debated. This study describes oncological patterns of care, prognostic factors, and survival for patients ≥ 70 years in France. We identified patients over 70 with newly diagnosed and histologically confirmed GBM on data previously published by the French Brain Tumor DataBase. We included 265 patients. Neurological deficits and mental status disorders were the most frequent symptoms. The surgery consisted of resection (RS n = 95) or biopsy (B n = 170); 98 patients did not have subsequent oncological treatment. After surgery, first-line treatment consisted of radiotherapy (RT n = 76), chemotherapy (CT n = 52), and concomitant radiochemotherapy (CRC n = 39). The median age at diagnosis was 76, 74, and 73 years, respectively, for the untreated, B + RT and/or CT, RS ± RT and/or CT groups. Median survival (in days, 95 % CI) with these main strategies, when analyzed according to surgical groups, was: B-CT n = 41, 199[155-280]; B-CRC n = 21, 318[166-480]; B-RT n = 37, 149[130-214]; RS-CT n = 11, 245[211-na]; RS-CRC n = 18, 372[349-593]; RS-RT n = 39, 269[218-343]. This population study for elderly GBM patients is one of the most important in Europe, and could be considered as a historical cohort to compare future treatments. Moreover, we can hypothesize that elderly patients (versus patients <70 years) are undertreated. Karnofsky performance status seems to be the most relevant clinical predictive factor, and RS and CRC have a positive impact on survival for elderly GBM patients in the general population, at least when feasible.
authors: Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi-Gui de Chauliac, Centre Hospitalier Universitaire, 80 avenue Augustin Fliche, 34 295, Montpellier cedex 5, France.
authors: Sonia
authors: S
authors: Zouaoui
authors: Amélie
authors: A
authors: Darlix
authors: Pascale
authors: P
authors: Fabbro-Peray
authors: Hélène
authors: H
authors: Mathieu-Daudé
authors: Valérie
authors: V
authors: Rigau
authors: Michel
authors: M
authors: Fabbro
authors: Faiza
authors: F
authors: Bessaoud
authors: Luc
authors: L
authors: Taillandier
authors: François
authors: F
authors: Ducray
authors: Fabienne
authors: F
authors: Bauchet
authors: Michel
authors: M
authors: Wager
authors: Thierry
authors: T
authors: Faillot
authors: Laurent
authors: L
authors: Capelle
authors: Hugues
authors: H
authors: Loiseau
authors: Christine
authors: C
authors: Kerr
authors: Philippe
authors: P
authors: Menei
authors: Hugues
authors: H
authors: Duffau
authors: Dominique
authors: D
authors: Figarella-Branger
authors: Olivier
authors: O
authors: Chinot
authors: Brigitte
authors: B
authors: Trétarre
authors: Luc
authors: L
authors: Bauchet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001932:Brain Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005602:France; D005909:Glioblastoma / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D005791:Patient Care; D012189:Retrospective Studies; D016896:Treatment Outcome