COT-01 Experience of introducing alternating electric field therapy for an elderly glioblastoma patient living alone

Abstract

Introduction: In December 2017, alternating electric field therapy (EFT) for glioblastoma was covered by insurance in Japan, but because of treatment complexity, the number of cases of introduction remains small, and the threshold for introduction is even higher for elderly patients living alone. Case presentation: The patient was an 84-year-old man, who are living alone, and an open biopsy was performed for a contrast-enhanced neoplastic lesion in the left frontal lobe. The clinical diagnosis was glioblastoma and Ki-67 was 60%. Following initial treatment, the tumor recurred within 1 month prior to the initiation of alternating EFT. Nonetheless, steroid was administered, he could not walk without aid and was forced get admitted on the day after the introduction, and rehabilitation treatment was instituted. Motor aphasia was slowly disappeared, and he could walk stably without help after 2 weeks and was discharged on day 28. Magnetic resonance imaging prior to discharge indicated that the tumor had shrunk and cerebral edema had ameliorated. Following discharge, the treatment could be continued with the help of a home-visiting nurse, and no adverse events were noted. Discussion: In the current case, treatment with temozolomide (TMZ) could not be conducted because of neutropenia, but alternating EFT may have been effective because of the high mitotic activity of the tumor. In Japan, from December 2017 to April 2020, alternating EFT was initiated in 440 patients, 5 (1.1%) of whom were patients living alone, including the current case. The other four were all men in their 50s and not elderly. Conclusion: In the case of elderly patients living alone, medical practitioners may be able to control the tumor by preparing the environment for alternating EFT for patients and keeping the patient willing to undergo treatment.