P01.138 Radio-chemotherapy with temozolomide in elderly patients with glioblastoma: our experience

Abstract

BACKGROUND: Glioblastoma multiforme (GBM) is the most aggressive brain tumor in adults and the second most common brain cancer after meningioma with a peak of incidence on the ffthy decades of life. Due to the progressive ageing of the developed country population, more than a half of new cases occurs in patients older than 65 years. The aim of the present study was to evaluate the clinical outcome of radio-chemotherapy with temozolomide in patients with glioblastoma aged more than 65 years. MATERIAL AND METHODS: Sixty-three patients treated with radiotherapy and chemotherapy at Pisa University Hospital between September 2004 and November 2017 were enrolled in this retrospective analysis. All patients had a proven diagnosis of glioblastoma grade IV WHO, ECOG PS 0-2, age ≥ 65. Radiotherapy was delivered in daily fractions of 2 Gy given 5 days per week for 6 weeks, for a total of 60 Gy. During radiotherapy, temozolomide was administered at a dose of 75 mg per square meter of body-surface area per day from the first to the last day of radiotherapy. 5-6 weeks after the end of radiotherapy, adjuvant temozolomide was administered at 150-200 mg per square meter for five consecutive days, every 28 days. A maximum of 12 cycles were prescribed if MRI showed no disease progression and temozolomide was well tolerated. RESULTS: Data analysis was performed in April 2018. The present study was performed in 37 male and 26 female patients with a median age at diagnosis of 72,5 years (range=65-89). Fifty-seven patients underwent surgical resection, four patients stereotactic diagnostic biopsy, two patients had a radiologic diagnosis only. During follow up, we recorded 46 cases of disease progression with a median progression-free survival (PFS) of 12 months (range 1-88 months). Median overall survival (OS) were 25 months (range 1-107 months); at data analysis, 65 patients were died. after disease recurrence, based on ECOG, tumor burden and age, patients were treated with surgery (15 cases), chemotherapy (30 cases) and re-irradiation (11 cases). CONCLUSION: In our experience, progression free survival and overall survival were similar to those reported in literature for younger patients. We think that radiochemotherapy is a good option for older patients with a good performance status in glioblastoma treatment.