Impact of therapeutic modalities on disease-specific survival in older adults with glioblastoma: A single-institution retrospective cohort study. (December 2019)

• Record Type: Journal Article
• Authors: Iskandar, Andrew S; Kerr, Wesley T; Hwang, Andrew; Farrell, Stephanie; Plaxe, Steven C; Dasanu, Constantin A
• Is Part Of: Journal of oncology pharmacy practice. Volume 25:Number 8(2019)
• Page Start: 1999
• Page End: 2003
• Publication Date: 2019-12
• Subjects: Elderly -- glioblastoma -- neurooncology -- radiation -- survival; Cancer -- Chemotherapy -- Periodicals; Clinical pharmacology -- Periodicals; 616.994061
• DOI: 10.1177/1078155219857792
• Languages: English
• ISSNs: 1078-1552

Abstract

The standard first-line therapy for glioblastoma consists of maximal surgical resection, followed by concurrent chemoradiotherapy. Optimal management for older glioblastoma patients is unknown as they have not been extensively studied in clinical trials. We report data from a series of 156 consecutive glioblastoma patients treated at our institution from 2007 to 2017. Compared to glioblastoma patients aged 70 or less, the patients older than 70 were less likely to undergo surgical resection (34% vs. 64%; p = 0.0003), be treated with adjuvant chemotherapy (37% vs. 59%; p = 0.01) or radiation therapy (36% vs. 56%; p = 0.03). Disease-specific survival was significantly shorter in this age group (4.7 vs. 15.3 months; p = 0.002). Nonetheless, when older patients did undergo surgery or chemotherapy, the proportional improvement in cancer-specific survival was similar to the one recorded in younger patients, which is concordant with the findings of other published reports. A multidisciplinary input from neurosurgeons, medical and radiation oncologists, oncology pharmacists and geriatricians remain paramount for the optimal management of glioblastoma in patients older than 70.