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

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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.

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Authors and Affiliations

  1. Department of Radiotherapy, Regional Oncology Center, ul. Bialska 104/118, 42-200, Czestochowa, Poland

    Joanna Socha

  2. Independent Public Care Facility of the Ministry of the Interior and Warmian & Mazurian Oncology Center, Olsztyn, Poland

    Lucyna Kepka

  3. Department of Radiotherapy, Alberta Health Services-Cancer/University of Alberta, Edmonton, Canada

    Sunita Ghosh & Wilson Roa

  4. Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India

    Narendra Kumar

  5. Department of Radiotherapy, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus

    Valery Sinaika

  6. Department of Radiotherapy, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil

    Juliana Matiello

  7. Department of Radiotherapy, High Technology Medical Center University Clinic, Tbilisi, Georgia

    Darejan Lomidze

  8. Department of Radiotherapy, A C Camargo Hospital, São Paolo, Brazil

    Douglas Guedes de Castro

  9. Department of Radiotherapy, Institut National de Cancer Salah Azaiz, Tunis, Tunisia

    Dalenda Hentati

  10. Applied Radiation Biology and Radiotherapy Section, International Atomic Energy Agency, Vienna, Austria

    Elena Fidarova

Authors
  1. Joanna Socha
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  2. Lucyna Kepka
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  3. Sunita Ghosh
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  4. Wilson Roa
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  5. Narendra Kumar
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  6. Valery Sinaika
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  7. Juliana Matiello
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  8. Darejan Lomidze
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  9. Douglas Guedes de Castro
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  10. Dalenda Hentati
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  11. Elena Fidarova
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Correspondence to Joanna Socha.

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Socha, J., Kepka, L., Ghosh, S. et al. Outcome of treatment of recurrent glioblastoma multiforme in elderly and/or frail patients. J Neurooncol 126, 493–498 (2016). https://doi.org/10.1007/s11060-015-1987-7

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  • DOI: https://doi.org/10.1007/s11060-015-1987-7

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