RTRB-21SURVIVAL ANALYSIS OF 161 ELDERLY PATIENTS TREATED WITH RADIOTHERAPY WITH CONCOMITANT AND ADJUVANT TEMOZOLOMIDE

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INTRODUCTION: Majority of patients with glioblastoma are 65 years and older at the time of diagnosis. There is no standard treatment regimen for this group of elderly patients. The treatment options will include radiation alone, radiation with concomitant and adjuvant temozolomide or temozolomide alone. METHODS: We reviewed the records of 161 GBM patients with age of 70 and above at the time of diagnosis from 2007 until 2014. The demographic information, KPS, type of surgery, MGMT methylation, IDH1 mutation, treatment and overall survival were collected and analyzed. RESULTS: 55% of the patients were males with median age of 76 years (range: 70 - 90) and KPS of 80 (range: 30 - 100). 119 (74%) of patients had surgical resection and 38 (24%) had biopsy only. MGMT methylation status was available in 68% of patients (109/61). MGMT was methylated in 56 (35%) patients and unmethylated in 53 (33%) patients. Majority of patients had no IDH1 mutation. Further treatments included 60 patients (37%) who received radiation 60 Gy with concomitant and adjuvant temozolomide, 29 (18%) were treated with radiation followed by adjuvant temozolomide, 24 (15%) had radiation alone, while 44 (27%) received no further treatment after the surgery. No patient received temozolomide alone. Median overall survival for all patients was 5.45 months. Kaplan-Meier -based analysis showed further treatment after surgery with standard radiation course of 60 Gy with concomitant and adjuvant temozolomide is associated with significantly higher survival (p< 0.001). CONCLUSION: Elderly patients with newly diagnosed glioblastoma may benefit from radiation for 60 Gy with concomitant and adjuvant temozolomide.

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