EP-1648 Radio-chemotherapy with temozolomide in elderly patients with glioblastoma: our experience

Purpose or Objective Glioblastoma multiforme (GBM) is the most aggressive brain tumor in adults and the second most common brain cancer after meningioma with a peak of incidence on the fifthy decades of life. Due to the progressive ageing of the developed country population, more than a half of new cases occurs in patients older than 65 years. The aim of the present study was to evaluate the clinical outcome of radio-chemotherapy with temozolomide in patients with glioblastoma aged more than 65 years. Material and Methods Sixty-three patients treated with radiotherapy and chemotherapy at Pisa University Hospital between September 2004 and November 2017 were enrolled in this retrospective analysis. All patients had a proven diagnosis of glioblastoma grade IV WHO, ECOG PS 0-2, age ≥ 65. Radiotherapy was delivered in daily fractions of 2 Gy given 5 days per week for 6 weeks, for a total of 60 Gy. During radiotherapy, temozolomide was administered at a dose of 75 mg per square meter of body-surface area per day from the first to the last day of radiotherapy. 5-6 weeks after the end of radiotherapy, adjuvant temozolomide was administered at 150-200 mg per square meter for five consecutive days, every 28 days. A maximum of 12 cycles were prescribed if MRI showed no disease progression and temozolomide was well tolerated. Results Data analysis was performed in April 2018. The present study was performed in 37 male and 26 female patients with a median age at diagnosis of 72,5 years (range=65-89). Fifty-seven patients underwent surgical resection, four patients stereotactic diagnostic biopsy, two patients had a radiologic diagnosis only.During follow up, we recorded 46 cases of disease progression with a median progression-free survival (PFS) of 12 months (range 1-88 months). Median overall survival (OS) were 25 months (range 1-107 months); at data analysis, 65 patients were died. After disease recurrence, based on ECOG, tumor burden and age, patients were treated with surgery (15 cases), chemotherapy (30 cases) and re-irradiation (11 cases). Conclusion In our experience, progression free survival and overall survival were similar to those reported in literature for younger patients. We think that radiochemotherapy is a good option for older patients with a good performance status in glioblastoma treatment