, Volume 113, Issue 2, pp 343-344
Date: 23 Mar 2013

‘Elderly’ patients with newly diagnosed glioblastoma deserve optimal care

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To the Editor,

The treatment of ‘elderly’ patients with newly diagnosed glioblastoma (GBM) has received considerable attention following the recently published results of two randomized, prospective, multicenter trials designed to establish optimal therapy in this patient population [1, 2]. The first trial, NOA-08, randomized 373 patients over the age of 65 years with anaplastic astrocytoma or GBM to either standard radiation (60 Gy in 30 fractions) or dose dense temozolomide (100 mg/m2 1 week on, 1 week off) [1]. The second trial, named the Nordic trial, randomized 342 patients over the age of 60 to three arms: (1) hypofractionated radiation (34 Gy in 10 fractions), (2) standard radiation, and (3) single-agent temozolomide (200 mg/m2 for five consecutive days every month) [2]. Both of these studies conclude that temozolomide alone was ‘not inferior’ to radiation, implying that single-agent chemotherapy should be considered as a standard of care in this patient population.

However, the