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Treatment outcomes in glioblastoma patients aged 76 years or older: a multicenter retrospective cohort study

Journal of Neuro-Oncology volume 116, pages 299–306 (2014)Cite this article

Abstract

Age is one of the most important prognostic factors in glioblastoma patients, but no standard treatment has been established for elderly patients with this condition. We therefore conducted a retrospective cohort study to evaluate treatment regimens and outcomes in elderly glioblastoma patients. The study population consisted of 79 glioblastoma patients aged ≥76 years (median age 78.0 years; 34 men and 45 women). The median preoperative Karnofsky performance status (KPS) score was 60. Surgical procedures were classified as biopsy (31 patients, 39.2 %), <95 % resection of the tumor (21 patients, 26.9 %), and ≥95 % resection of the tumor (26 patients, 33.3 %). Sixty-seven patients (81.0 %) received radiotherapy and 45 patients (57.0 %) received chemotherapy. The median overall progression-free survival time was 6.8 months, and the median overall survival time was 9.8 months. Patients aged ≥78 years were significantly less likely to receive radiotherapy (p = 0.004). Patients with a postoperative KPS score of ≥60 were significantly more likely to receive maintenance chemotherapy (p = 0.008). Multivariate analyses identified two independent prognostic factors: postoperative KPS score ≥60 (hazard ratio [HR] = 0.531, 95 % confidence interval [CI] 0.315–0.894, p = 0.017) and temozolomide therapy (HR = 0.442, 95 % CI 0.25–0.784, p < 0.001).The findings of this study suggest that postoperative KPS score is an important prognostic factor for glioblastoma patients aged ≥76 years, and that these patients may benefit from temozolomide therapy.

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Acknowledgments

We are grateful to Dr. Haruyasu Fujita, Department of Socio-Environmental Medicine, Public Health Division, Gunma University Graduate School of Medicine, Gunma, Japan, for his advice on the statistical analyses.

Conflict of interest

There are no conflicts of interest to declare.

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Affiliations

  1. Department of Neurosurgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-chou, Chuo-ku, Niigata, 951-8566, Japan

    Takeo Uzuka

  2. Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan

    Kenichiro Asano & Hiroki Ohkuma

  3. Department of Neurosurgery, Akita University Graduate School of Medicine, Akita, Japan

    Toshio Sasajima & Kazuo Mizoi

  4. Department of Neurosurgery, Yamagata University School of Medicine, Yamagata, Japan

    Kaori Sakurada & Takamasa Kayama

  5. Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan

    Toshihiro Kumabe & Teiji Tominaga

  6. Department of Neurosurgery, Iwate Medical University, Morioka, Japan

    Takaaki Beppu & Kuniaki Ogasawara

  7. Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan

    Masahiro Ichikawa & Kiyoshi Saito

  8. Department of Molecular Cancer Science, Yamagata University School of Medicine, Yamagata, Japan

    Chifumi Kitanaka

  9. Department of Neurosurgery, Brain Research Institute, University of Niigata, Niigata, Japan

    Hiroshi Aoki & Yukihiko Fujii

Authors
  1. Takeo Uzuka
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  2. Kenichiro Asano
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  3. Toshio Sasajima
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  4. Kaori Sakurada
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  5. Toshihiro Kumabe
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  7. Masahiro Ichikawa
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  8. Chifumi Kitanaka
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  9. Hiroshi Aoki
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  10. Kiyoshi Saito
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  11. Kuniaki Ogasawara
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  12. Teiji Tominaga
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  13. Kazuo Mizoi
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  14. Hiroki Ohkuma
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  15. Yukihiko Fujii
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  16. Takamasa Kayama
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Tohoku Brain Tumor Study Group

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Correspondence to Takeo Uzuka.

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Uzuka, T., Asano, K., Sasajima, T. et al. Treatment outcomes in glioblastoma patients aged 76 years or older: a multicenter retrospective cohort study. J Neurooncol 116, 299–306 (2014). https://doi.org/10.1007/s11060-013-1291-3

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  • DOI: https://doi.org/10.1007/s11060-013-1291-3

Keywords

  • Glioblastoma
  • Karnofsky performance status score
  • Elderly patients
  • Temozolomide