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SHR Neuro Cancer Cardio Lipid Metab 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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Leading authors Med Uni Graz
Hoffermann Markus
Co-authors Med Uni Graz
Asslaber Martin
Bruckmann Lukas
Mahdy Ali Kariem
Payer Franz
von Campe Gord

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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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Extent of resection
Malignant Primary Brain Tumors
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