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Journal of Neuro-Oncology

, Volume 126, Issue 3, pp 493–498 | Cite as

Outcome of treatment of recurrent glioblastoma multiforme in elderly and/or frail patients

  • Joanna Socha
  • Lucyna Kepka
  • Sunita Ghosh
  • Wilson Roa
  • Narendra Kumar
  • Valery Sinaika
  • Juliana Matiello
  • Darejan Lomidze
  • Douglas Guedes de Castro
  • Dalenda Hentati
  • Elena Fidarova
Clinical Study

Abstract

Optimal treatment of recurrent glioblastoma multiforme (rGBM) in elderly and/or frail patients remains virtually unexplored, the best supportive care (BSC) only is routinely administered due to the fatal prognosis. We evaluated the impact of different treatment methods on post-progression survival (PPS) and overall survival (OS) of such patients. Data from 98 elderly and/or frail rGBM patients, treated initially with 1-week or 3-week radiotherapy (RT) within the phase III IAEA study (2010–2013), were analyzed. KPS at relapse and salvage treatment methods were recorded. Kaplan–Meier method was used to estimate PPS and OS for different treatment modalities. Eighty-four patients experienced recurrence: 47 (56 %) received BSC, 21 (25 %)—chemotherapy (CHT), 8 (9.5 %)—surgery, 3 (3.5 %)—RT, for 5 (6 %) the data was unavailable. Median OS from randomization for all 84 patients was 35 weeks: 55 versus 30 weeks for any treatment versus BSC, p < 0.0001. Median PPS was 15 weeks: 23 weeks with any treatment versus 9 weeks with BSC, p < 0.0001. For local treatment (surgery and/or RT) median PPS was 51 versus 21 weeks for CHT, p = 0.36. In patients with poor KPS (≤60) at relapse median PPS was 9 weeks with BSC versus 21 weeks with any treatment, p = 0.014. In poor KPS patients median PPS for local treatment was 14 weeks versus 21 weeks with CHT, p = 0.88. An active therapeutic approach may be beneficial for selected elderly and/or frail rGBM patients. Poor KPS patients may also benefit from active treatment, but there is no benefit of local treatment over CHT.

Keywords

Recurrent glioblastoma multiforme Elderly patients Frail patients Salvage therapy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Joanna Socha
    • 1
  • Lucyna Kepka
    • 2
  • Sunita Ghosh
    • 3
  • Wilson Roa
    • 3
  • Narendra Kumar
    • 4
  • Valery Sinaika
    • 5
  • Juliana Matiello
    • 6
  • Darejan Lomidze
    • 7
  • Douglas Guedes de Castro
    • 8
  • Dalenda Hentati
    • 9
  • Elena Fidarova
    • 10
  1. 1.Department of RadiotherapyRegional Oncology CenterCzestochowaPoland
  2. 2.Independent Public Care Facility of the Ministry of the Interior and Warmian & Mazurian Oncology CenterOlsztynPoland
  3. 3.Department of RadiotherapyAlberta Health Services-Cancer/University of AlbertaEdmontonCanada
  4. 4.Department of Radiotherapy & OncologyPost Graduate Institute of Medical Education & Research (PGIMER)ChandigarhIndia
  5. 5.Department of RadiotherapyN.N. Alexandrov National Cancer Centre of BelarusMinskBelarus
  6. 6.Department of RadiotherapyIrmandade da Santa Casa de Misericórdia de Porto AlegrePorto AlegreBrazil
  7. 7.Department of RadiotherapyHigh Technology Medical Center University ClinicTbilisiGeorgia
  8. 8.Department of RadiotherapyA C Camargo HospitalSão PaoloBrazil
  9. 9.Department of RadiotherapyInstitut National de Cancer Salah AzaizTunisTunisia
  10. 10.Applied Radiation Biology and Radiotherapy SectionInternational Atomic Energy AgencyViennaAustria

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