Giuseppe Minniti1, Claudia Scaringi2, Gaetano Lanzetta3, Irene Terrenato4, Vincenzo Esposito3, Antonella Arcella3, Andrea Pace5, Felice Giangaspero3, Alessandro Bozzao6, Riccardo Maurizi Enrici2. 1. Radiation Oncology Unit, Sant' Andrea Hospital, University Sapienza, Rome, Italy; Scientific Institute for Research, Hospitalization and Health Care (IRCCS) Neuromed, Pozzilli, Italy. Electronic address: gminniti@ospedalesantandrea.it. 2. Radiation Oncology Unit, Sant' Andrea Hospital, University Sapienza, Rome, 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.
Abstract
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(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 a reasonable therapeutic approach for these patients, without loss of survival benefit and acceptable toxicity.
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(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 a reasonable therapeutic approach for these patients, without loss of survival benefit and acceptable toxicity.
Authors: Rifaquat Rahman; Paul J Catalano; David A Reardon; Andrew D Norden; Patrick Y Wen; Eudocia Q Lee; Lakshmi Nayak; Rameen Beroukhim; Ian F Dunn; Alexandra J Golby; Mark D Johnson; E Antonio Chiocca; Elizabeth B Claus; Brian M Alexander; Nils D Arvold Journal: J Neurooncol Date: 2015-06-02 Impact factor: 4.130
Authors: Marc Zanello; Alexandre Roux; Renata Ursu; Sophie Peeters; Luc Bauchet; Georges Noel; Jacques Guyotat; Pierre-Jean Le Reste; Thierry Faillot; Fabien Litre; Nicolas Desse; Evelyne Emery; Antoine Petit; Johann Peltier; Jimmy Voirin; François Caire; Jean-Luc Barat; Jean-Rodolphe Vignes; Philippe Menei; Olivier Langlois; Edouard Dezamis; Antoine Carpentier; Phong Dam Hieu; Philippe Metellus; Johan Pallud Journal: J Neurooncol Date: 2017-07-19 Impact factor: 4.130