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Title: Standard (60 Gy) or Short-Course (40 Gy) Irradiation Plus Concomitant and Adjuvant Temozolomide for Elderly Patients With Glioblastoma: A Propensity-Matched Analysis

Purpose: To evaluate 2 specific radiation schedules, each combined with temozolomide (TMZ), assessing their efficacy and safety in patients aged ≥65 years with newly diagnosed glioblastoma (GBM). Methods and Materials: Patients aged ≥65 years with Karnofsky performance status (KPS) ≥60 who received either standard (60 Gy) or short-course (40 Gy) radiation therapy (RT) with concomitant and adjuvant TMZ between June 2004 and October 2013 were retrospectively analyzed. A propensity score analysis was executed for a balanced comparison of treatment outcomes. Results: A total of 127 patients received standard RT-TMZ, whereas 116 patients underwent short-course RT-TMZ. Median overall survival and progression-free survival times were similar: 12 months and 5.6 months for the standard RT-TMZ group and 12.5 months and 6.7 months for the short-course RT-TMZ group, respectively. Radiation schedule was associated with similar survival outcomes in either unadjusted or adjusted analysis. O{sup 6}-methylguanine-DNA methyltransferase promoter methylation was the most favorable prognostic factor (P=.0001). Standard RT-TMZ therapy was associated with a significant rise in grade 2 and 3 neurologic toxicity (P=.01), lowering of KPS scores during the study (P=.01), and higher posttreatment dosing of corticosteroid (P=.02). Conclusions: In older adults with GBM, survival outcomes of standard and short-course RT-TMZ were similar. An abbreviated course of RT plus TMZ may represent amore » reasonable therapeutic approach for these patients, without loss of survival benefit and acceptable toxicity.« less
Authors:
 [1] ;  [2] ;  [1] ;  [3] ;  [4] ; ;  [3] ;  [5] ;  [3] ;  [6] ;  [1]
  1. Radiation Oncology Unit, Sant' Andrea Hospital, University Sapienza, Rome (Italy)
  2. (IRCCS) Neuromed, Pozzilli (Italy)
  3. Scientific Institute for Research, Hospitalization and Health Care (IRCCS) Neuromed, Pozzilli (Italy)
  4. Biostatistic Unit, Regina Elena National Cancer Institute, Rome (Italy)
  5. Neurology Unit, Regina Elena National Cancer Institute, Rome (Italy)
  6. Neuroradiology Unit, Sant' Andrea Hospital, University Sapienza, Rome (Italy)
Publication Date:
OSTI Identifier:
22423845
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 91; Journal Issue: 1; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; COMPARATIVE EVALUATIONS; CORTICOSTEROIDS; DIAGNOSIS; DNA; ELDERLY PEOPLE; GLIOMAS; METHYL TRANSFERASES; METHYLATION; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SCHEDULES; TOXICITY