Abstract
BACKGROUND
Glioblastoma (GBM) occurs commonly in individuals above 65 years of age. Most clinical trials that guide recommendations for treatment of GBM tend to exclude patients above the age of 65 years. In this study, we evaluated a cohort of elderly patients treated at a single institution in order to identify factors that impact overall survival.
METHODS
A retrospective review was performed of elderly patients (≥ 65 years old) with newly diagnosed GBM treated between 2013 and 2016. Tumor volumetric analysis was performed using the Osirix software. Various characteristics were evaluated in univariate and multivariate stepwise models to examine their effects on overall survival.
RESULTS
63 patients were included in the study with a median age of 72 years. Tumors most frequently involved the temporal lobe (36.5%), followed by the frontal lobe (34.9 %), parietal (30.1%), and occipital (6.3%) lobes. Pre-operative tumor volume was 30.6 cm3. Four patients (6.3%) underwent biopsy only and the remaining 93.7% of patients underwent resection with many (55%) having gross-total resection (GTR). The majority (95.2%) of the patients received postoperative radiotherapy or radiotherapy and concurrent temozolomide. The mean survival for all patients was 12 months; three patients experienced long-term (≥ 2-year) survival. Extent of resection was seen to significantly impact overall survival; patients who underwent GTR had a median survival of 15.8 months, whereas those who underwent subtotal resection had survival of 9.8 months (p<0.05).
CONCLUSION
This study demonstrates that extent of resection positively influences overall survival in elderly patients with GBM, suggesting that safe maximal resection should be considered. Furthermore, administration of the postoperative chemoradiotherapy can improve survival and quality of life for this elderly patient population.