Glioblastoma in elderly patients: A retrospective analysis of survival and response based on molecular and clinical characteristics—Experience in our centre.

Abstract

e14054 Background: Glioblastoma (GBM) is the most lethal and the most common malignant central nervous system tumor in adults. The standard treatment includes surgery, radiotherapy (Rt) and temozolomide based chemotherapy (Qt). However, compared with younger population, overall survival (OS) is worse in elderly patients and, additionally, this group is not usually included in clinical trials. Retrospective studies have shown, among other factors, tumor biology and performance status with poorer survival in older population, but it is necessary further research in order to discover prognostic factors and optimize management in this group. Methods: In this retrospective study we analyzed clinical and tumor biology characteristics in older population (≥ 70 years) and we also compared these results with younger population (< 70 years) for the purpose of enhance clinical outcomes. From November-2016 to October-2022, we analyzed 111 patients in our hospital: group A (< 70 years): 80 patients, group B (≥ 70 years): 31 patients. The tumor biology and patient characteristics are described in the table. Results: OS was statistically better in group A (A 13.93 +/- 1.28 months versus B 9.39 +/- 1.45 months; p=0.035). In contrast of A, in B no differences in OS were observed related with type of surgery (p=0.78), MGMT status (p=0.4) or p53 status (p=0.75). However, significant differences in OS were observed in B in multivariate analysis according to modality of adjuvant treatment (greater OS in Qt-Rt+ Qt > Qt-Rt > Rt exclusively > no treatment; p<0.001) and performance status (greater OS in PS 0 > PS 1 > PS 2 > PS 3; p=0.001). There was no differences of OS between A and B if the adjuvant treatment was concomitant Qt-Rt +/- Qt (p=0.81), but with this therapy there was a toxic death (infection Grade 5) in B group. Other relevant toxicities Grade 3/4 in this group with Qt-Rt +/-Qt were: infection 3.2%, thrombocytopenia 12.9%, neutropenia 12.9%, leukopenia 6.45%, anemia 3.2%, thrombosis 3.2% Conclusions: Temozolomide based therapy is an effective and safe option for the treatment of patients ≥ 70 years with GBM. We need to perform prospective trials in this population in order to recognize prognostic and predictive factors to allow better treatment selection.[Table: see text]