Glioblastoma treatment in the elderly in the temozolomide therapy era

Background: Optimal treatment of glioblastoma (GBM) in the elderly remains unclear. The impact of age on treatment planning, toxicity, and efficacy at a Canadian Cancer Centre was retrospectively reviewed. Methods: Glioblastoma patients treated consecutively between 2004 and 2008 were reviewed. Utilizing 70 years as the threshold for definition of an elderly patient, treatments and outcome were compared in younger and elderly populations. Results: Four hundred and twenty one patients were included in this analysis and median overall survival (OS) for the entire cohort was 9.8 months. 290 patients were aged 70 who were treated with radiotherapy received 70 demonstrated inferior survival (one year OS 16% versus 54% for those 30 Gy to 70 versus <70 (HR 1.47, P=0.02) respectively. Conclusions: In this retrospective single institution series, elderly patients were more likely to be treated with BSC or palliative doses of radiotherapy. Randomized phase III study results are required for guidance in treatment of this population of patients.