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Outcome of conventional treatment and prognostic factor in elderly glioblastoma patients

Acta Neurochirurgica volume 156, pages 641–651 (2014)Cite this article

Abstract

Background

Glioblastoma (GBM) is the most life-threatening primary brain tumour. Especially in elderly patients, a poorer outcome is noticeable. Until now, the effectiveness of the conventional active treatment has been controversial. The purpose of this study is to find the optimal treatment for elderly patients with newly diagnosed GBM.

Method

The authors retrospectively reviewed 301 patients who were diagnosed with GBM at a single centre from January 2006 to December 2010. All patients were divided into younger and elderly groups based on the cut-off age of 65 years, and the treatment outcome was analysed.

Results

Of 301 patients, 67 (23.3 %) patients were 65 years old or older, and 234 (77.7 %) patients were younger than 65 years. In the elderly group, 49 patients received surgical resection and 18 patients received biopsy. Forty-seven patients (70.1 %) underwent concomitant chemoradiotherapy (CCRT) and 38 patients (56.7 %) underwent adjuvant temozolomide (TMZ) chemotherapy. The median overall survival (OS) of elderly patients was 12.0 months and the progression-free survival (PFS) was 8.5 months. The median OS of elderly patients who underwent CCRT and adjuvant TMZ chemotherapy increased to 16.2 months. On the multivariate analysis, tumour infiltration (p = 0.005), and resection (p = 0.001) were significant independent prognostic factors in elderly patients. The grade 3 or 4 complication rate was not statistically different between the younger group (n = 22, 9.4 %) and the elderly group (n = 8, 12 %).

Conclusion

Elderly patients diagnosed with GBM had a survival benefit and a low complication rate with the conventional treatment. Therefore, elderly patients should be encouraged to receive the conventional active treatment.

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Acknowledgments

This work was supported by the Global Frontier Project grant (NRF-2012M3A6A-2010-0029781) of National Research Foundation funded by the Ministry of Education, Science and Technology of Korea and by a grant of the Korea Healthcare Technology R&D Project, Ministry for Health and Welfare Affairs (A092255).

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Affiliations

  1. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea

    Sung Woon Oh, Tae Keun Jee, Doo-Sik Kong, Do-Hyun Nam, Jung-Il Lee & Ho Jun Seol

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  1. Sung Woon Oh
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Correspondence to Ho Jun Seol.

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Oh, S.W., Jee, T.K., Kong, DS. et al. Outcome of conventional treatment and prognostic factor in elderly glioblastoma patients. Acta Neurochir 156, 641–651 (2014). https://doi.org/10.1007/s00701-014-2020-1

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  • DOI: https://doi.org/10.1007/s00701-014-2020-1

Keywords

  • Glioblastoma
  • Conventional Treatment
  • Temozolomide
  • Elderly
  • Complication