title: Outcome evaluation in glioblastoma patients older than 65 years: Importance of individual assessment of treatment tolerance.
abstract: BACKGROUND
  In this retrospective study, we evaluated the outcome of patients with primary glioblastoma multiforme (GBM), aged >= 65 years, treated in our institution from 2003 to 2009, and compared the outcome of patients admitted into the Nordic Glioma Study (NGS group) to the outcomes of elderly patients treated during the same time period outside of studies. The primary endpoint was overall survival (OS).
  
  
  METHODS
  The study population of 70 patients (32 females) aged 65 - 83, median 71 years, was divided into three groups: the NGS group consisted of 35 patients, 1 group of 12 patients estimated as frail was treated with back then standard radiotherapy of 60 Gy (RT arm), and 23 "fit elderly" were treated with standard radio-chemotherapy (RCT arm). 31 of the 70 patients underwent gross total resection (44%), 21 patients had subtotal resection (30%), and 18 patients underwent biopsy (26%).
  
  
  RESULTS
  Survival in the three study arms of the NGS group was very similar to the outcomes in the whole cohort of the Nordic Glioma Study (6 - 10 months). Median OS in the RCT arm was 21.0 (6 - 47) months vs. 3.0 (0.3 - 21) months in the RT arm of the NGS group. In the temozolomide (TMZ) arm, 2 of 10 patients (20%) suffered from grade 3 - 4 thrombocytopenia. In the RCT arm, grade 3 hematologic toxicity occurred in 2 of 23 patients (8.7%) and in 1 patient of the RT arm (8.3%). This retrospective single center experience shows the wide variety of outcomes in elderly patients with GBM and underlines their need for individualized, geriatric assessment-based therapy planning.
authors.forename: Michael
authors.initials: M
authors.lastname: Ackerl
authors.forename: Birgit
authors.initials: B
authors.lastname: Flechl
authors.forename: Karin
authors.initials: K
authors.lastname: Dieckmann
authors.forename: Matthias
authors.initials: M
authors.lastname: Preusser
authors.forename: Georg
authors.initials: G
authors.lastname: Widhalm
authors.forename: Cornelia
authors.initials: C
authors.lastname: Sax
authors.forename: Christine
authors.initials: C
authors.lastname: Marosi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide