Short-course radiotherapy in elderly patients with glioblastoma: feasibility and efficacy of results from a single centre

Abstract

The incidence of glioblastoma (GBM) in the elderly population is currently increasing, with a peak seen between 65 and 84years. The optimal treatment in terms of both efficacy and quality of life still remains a relevant and debated issue today. The purpose of our study was to evaluate the feasibility of short-course hypofractionated accelerated radiotherapy (HART) in GBM patients aged over 70years and with a good Karnofsky performance score (KPS). A review of medical records at the "Istituto Neurologico C. Besta" was undertaken; patients aged ≥ 70years who had undergone adjuvant HART for GBM between January 2000 and January 2004 were included in the study. HART was administered to a total dose of 45Gy, 2.5Gy/fraction, in three daily fractions for three consecutive days/cycle fractions each, delivered in two cycles (split 15days). A total of 33patients were evaluable for the current analysis. Median follow-up was 10months. According to CTCAE (version 3.0) criteria, none of the patients developed radiation-induced neurological status deterioration or necrosis. KPS evaluation after HART was found to be stable in 73 % of patients, improved in 24 %, and worse in 3 %. The median overall survival time of the entire study population was 8months (range 2-24). Our findings suggest that a hypofractionated accelerated schedule can be a safe and effective option in the treatment of GBM in the elderly.