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07.08.2018 | Clinical Study

Treatment recommendations for elderly patients with newly diagnosed glioblastoma lack worldwide consensus

Zeitschrift:
Journal of Neuro-Oncology
Autoren:
Joshua D. Palmer, Deepak Bhamidipati, Minesh Mehta, Noelle L. Williams, Adam P. Dicker, Maria Werner-Wasik, Wenyin Shi
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s11060-018-2969-3) contains supplementary material, which is available to authorized users.
This publication was previously presented at the 20th Annual Society for Neuro-oncology and won the Best Oral Presentation Award.

Abstract

Background

Glioblastoma predominantly occurs in the 6th and 7th decades of life. The optimal treatment paradigm for elderly patients is not well established. We sampled current worldwide management strategies for elderly patients with newly diagnosed glioblastoma.

Methods

A web-based survey was developed and distributed to 168 radiation oncologists, neuro-oncologists and neurosurgeons identified through the United Council for Neurologic Subspecialties and the CNS committees for North American, European and Asian Organizations. Questions addressed treatment recommendations in order to determine whether management consensus exists in this patient subset.

Results

There were 68 (40%) respondents. Across respondents, the most important factors directing treatment were KPS (94%) and MGMT methylation status (71%). Only 37% of respondents strictly factor in age when making treatment recommendations with 59% defining elderly as greater than 70 years-old. The most common treatment recommendations for MGMT-methylated elderly patients with KPS > 70 were as follows: standard chemoRT (49%), short course chemoRT (39%), and temozolomide alone (30%). The most common treatment recommendations for MGMT-unmethylated patients with KPS > 70 were as follows: short course RT alone (51%), standard chemoRT (38%), and short course chemoRT (28%). Treatment recommendations for patients with KPS < 50 were short course RT alone (40%), best supportive care (57%), or TMZ alone (17%). Individuals practicing in North America were significantly more likely to recommend standard chemoradiation for patients compared to their European counterparts.

Conclusion

Worldwide treatment recommendations for elderly patients with newly diagnosed GBM vary widely. Further randomized studies are needed to elucidate the optimal treatment strategy for this subset of patients.

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Zusatzmaterial
Supplementary material 1 (DOCX 21 KB)
11060_2018_2969_MOESM1_ESM.docx
Literatur
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