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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Hoffermann, M; Bruckmann, L; Kariem Mahdy, A; Asslaber, M; Payer, F; von Campe, G.
Treatment results and outcome in elderly patients with glioblastoma multiforme--a retrospective single institution analysis.
Clin Neurol Neurosurg. 2015; 128(2):60-69 Doi: 10.1016/j.clineuro.2014.11.006
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Führende Autor*innen der Med Uni Graz

Hoffermann Markus

Co-Autor*innen der Med Uni Graz

Asslaber Martin

Bruckmann Lukas

Mahdy Ali Kariem

Payer Franz

von Campe Gord

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Abstract:

Although glioblastoma multiforme is more common in patients older than 65 years, the elderly population is often excluded from clinical studies. Decision making in this subgroup can be challenging due to the lack of evidence for different neurosurgical and adjuvant treatment strategies. In this retrospective study, we evaluated clinical, treatment and survival data of 124 consecutive patients over 65 years of age with supratentorial glioblastoma multiforme. Median OS was 6.0 months (std. error 0.783, 95% CI 4.456-7.535). Mean OS was 9.7 months (std. error 0.830, 95% CI 8.073-11.327). In univariate regression analysis, low KPS was of negative prognostic value (p < 0.006 for KPS ≤ 80), while greater advanced age did not have any impact on survival (p = 0.591 for differences between groups). Gross total resection and subtotal resection led to significantly improved overall survival (median 15.0 and 11.0 months; p < 0.02) compared to partial resection or biopsy (both 4.0 months), but complications were more common in subtotal and partial resections. The last observation did not reach statistical significance (p = 0.06). Combinations of irradiation and Temozolomide chemotherapy proved to be more effective than other adjuvant therapies. Extent of resection (gross total resection vs. all others) and form of adjuvant treatment were the only factors of independent prognostic value in multivariate analysis (p = 0.031 and p < 0.001, respectively). It appears that more aggressive treatment regimens can lead to longer overall survival in elderly glioblastoma multiforme patients. Gross total resection should be offered whenever safely possible; otherwise, biopsy may be preferred. Non-surgical treatment should consist of postoperative radiotherapy and concomitant and/or adjuvant chemotherapy. Possibly higher rates of hematological side effects in concomitant chemotherapy need to be further investigated. Copyright © 2014 Elsevier B.V. All rights reserved.

Find related publications in this database (using NLM MeSH Indexing)

Age Factors -

Aged -

Aged, 80 and over -

Antineoplastic Agents, Alkylating - therapeutic use

Combined Modality Therapy -

Dacarbazine - analogs & derivatives

Dacarbazine - therapeutic use

Female -

Glioblastoma - drug therapy

Glioblastoma - mortality

Glioblastoma - radiotherapy

Glioblastoma - surgery

Humans -

Karnofsky Performance Status -

Male -

Neoplasm Grading -

Retrospective Studies -

Supratentorial Neoplasms - drug therapy

Supratentorial Neoplasms - mortality

Supratentorial Neoplasms - radiotherapy

Supratentorial Neoplasms - surgery

Temozolomide -

Treatment Outcome -

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Elderly

Extent of resection

Glioblastoma

Malignant Primary Brain Tumors

Temozolomide

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