HOUT-32. SIGNIFICANCE OF COMORBIDITY INDEX IN ELDERLY PATIENTS WITH GLIOBLASTOMA

Abstract

BACKGROUND: Comorbidity is a common problem in the treatment of elderly patients, but there is no standard method of the evaluation in glioblastoma patients. Charlson comorbidity index (CCI) has been proposed as the prognostic index associating with the prognosis of various diseases. CCI is calculated by weighting against comorbidities such as congestive heart failure, COPD, diabetes, liver renal disease, and cancer-bearing condition. We examined the relationship between CCI and prognosis of elderly patients with glioblastoma. METHODS: 28 patients over 70 years treated at our hospital from Dec.2006 to Dec.2016. 16 males and 12 females. Average age 76.8 years (70-86 years old). Relationship to overall survival (OS) was examined focusing on the age, CCI at hospitalization, Karnofsky Performance Status (KPS), surgery, radiotherapy (standard and hypofractionated), temozolomide-based chemotherapy. RESULTS: There was no significant correlation between age and CCI, but a weak negative correlation between KPS and CCI (r = - 0.302). Mean OS was 13.5 months in the resection group, 8.6 m in the biopsy group and 9.2 months in the non-surgery group. OS was longer in the resection group, but no difference in CCI. No significant difference in OS between standard radiotherapy with TMZ and hypofractionated radiotherapy with TMZ (13.2 m vs 11.5 m), with no concern to CCI. OS tended to be shorter in the high CCI group (8.6 m vs 14.5 m). DISCUSSION: The presence of comorbidities is one of the factors related to prognosis, and glioblastoma affecting the brain is in a disadvantageous condition due to cognitive dysfunction and paralysis. Since surgical excision and radiation chemotherapy lead to improvement in prognosis even in the elderly, it is important to complete the treatment paying maximum attention to the management of comorbidities. CCI would be useful to evaluate comorbidities. Further examination is needed in large cohort.