Glioblastoma, which is the most commonly diagnosed primary CNS neoplasm, is more frequent in individuals aged 65 years or more. Our purpose is to identify how glioblastoma diagnosed in elderly population is treated by Spanish oncologists.
Material and Methods
A survey was emailed to all members of Spanish Group for Neuro-oncology Research (GEINO).
Twenty-six neuro-oncologists from 26 hospitals completed the survey. The answers were different depending on the age, performance status, and MGMT methylation status. Patients between 65 and 70 years of age are mainly treated with Stupp treatment. For patients between ages of 70 and 80 years, 46.2% made recommendations for Perry regimen, for both methylated and non-methylated patients. For patients older than 80 years, monotherapy treatment is considered more frequently. In cases of non-MGMT promoter methylation, systemic therapy with temozolomide is still recommended in many hospitals.
Our research demonstrates there is no uniform approach to the management of elderly patients with glioblastoma among academic neuro-oncologists.
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Hess KR, Broglio KR, Bondy ML. Adult glioma incidence trends in the United States, 1977–2000. Cancer. 2004;101:2293–9.
Vuorinen V, Hinkka S, Färkkilä M, Jääskeläinen J. Debulking or biopsy of malignant glioma in elderly people - a randomised study. Acta Neurochir (Wien). 2003;145:5–10.
Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352:987–96.
Ostrom QT, Gittleman H, Fulop J, Liu M, Blanda R, Kromer C, et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2008–2012. Neuro Oncol. 2015;17(suppl 4):iv1–iv62.
Keime-Guibert F, Chinot O, Taillandier L, Cartalat-Carel S, Frenay M, Kantor G, et al. Radiotherapy for glioblastoma in the elderly. N Engl J Med. 2007;356:1527–35.
Vourinen V, Hinkka S, Färkkilä M, Jääskeläinen J. Debulking or biopsy of malignant glioma in elderly people-a randomized study. Acta Nuerochir (Wien). 2003;145(1):1–5.
Roa W, Brasher PM, Bauman G, Anthes M, Bruera E, Chan A, et al. Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial. J Clin Oncol. 2004;22:1583–8.
Malmström A, Grønberg BH, Marosi C, Stupp R, Frappaz D, Schultz H, et al. Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol. 2012;13:916–26.
Wick W, Platten M, Meisner C, Felsberg J, Tabatabai G, Simon M, Nikkhah G, Papsdorf K, et al. Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytom in elderly people: the NOA-08 randomised, phase 3 trail. Lancet Oncol. 2012;13(7):707–15.
Malmstrom A, Gronberg BH, Stupp R, et al. Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol. 2012;13(9):916–26.
Minniti G, De Sanctis V, Muni R, Filippone F, Bozzao A, Valeriani M, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma in elderly patients. J Neurooncol. 2008;88:97–103.
Minniti G, Lanzetta G, Scaringi C, Caporello P, Salvati M, Arcella A, et al. Phase II study of short-course radiotherapy plus concomitant and adjuvant temozolomide in elderly patients with glioblastoma. Int J Radiat Oncol Biol Phys. 2012;83:93–9.
Brandes AA, Franceschi F, Tosoni A, et al. Temozolomide concomitant and adjuvant to radiotherapy in elderly patients with glioblastoma: correlation with MGMT methylation status. Cancer. 2009;115(15):3512–8.
Perry JR, Laperriere N, O'Callaghan CJ, et al. Short-course radiation plus temozolomide in elderly patients with glioblastoma. N Engl J Med. 2017;376(11):1027.
Lombardi G, Bergo E, Bellu L, Caccese M, Letterio A, Tierno G, Pambuku A, Brunello A, Zagonel V. Comprehensive Geriatric Assessment (CGA) for outcome prediction in elderly patients (PTS) with glioblastoma (GBM): a mono-institutional experience. ESMO. 2018;29:mdy273–mdy369.
Clone M, D’Amico R, Lebovic J, Nazarian M, Zacharia BE, Sisti MB, et al. Frailty in Geriatric Glioblastoma Patients: a predictor of operative morbidity and outcome. World Neurosurg. 2016;89:362–7.
Hegi ME, Diserens A-C, Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N engl J Med. 2005;352(10):997–1003.
Wick W, Engel C, Combs SE, et al. NOA-08 randomized phase III trial of 1-week-on/1-week-off temozolomide versus involved field radiotherapy in elderly (older tan age 65) patients with newly diagnosed glioblastoma. J Clin Oncol. 2010;28:LBA2001.
Malmstrom A, Gronberg BH, Stupp R, et al. Glioblastoma in elderly patients: a randomized phase III trial comparing survival in patients treats with 6-week radiotherapy versus hypofractionated RT over 2 week versus temozolomide single agent. J Clin Oncol. 2010;28:LBA2002.
Van den Bent MJ, Baumert B, Erridge SC, et al. Interim results from the CATNON trial (EORTC study 26053–22054) of treatment with concurrent and adjuvant temozolomide for 1p/19q non-co-deleted anaplastic glioma: a phase 3, randomised, open-label intergroup study. Lancet. 2017;390:1645.
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, editors. WHO classification of tumours of the central nervous system. 4th ed. Lyon: IARC; 2016.
We thank the collaboration of the oncologists who have sent the surveys: M. A. Vaz Salgado, A. Rodriguez Sánchez, T. Quintanar, M. Navarro Martin, M. Vieito Villar, J. Cano, S. González, S. Ros, A. Herrero, M. A. Ivars, M. Lloret, M. Alonso, I. Moya, R. Luque, M. Benavides, M. Gutiérrez Toribio, and J. García-Gómez.
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Vaz Salgado, M.A., Torres, J., Esteban, J. et al. Survey of treatment recommendations for elderly patients with glioblastoma. Clin Transl Oncol (2019). https://doi.org/10.1007/s12094-019-02260-2