Survival Outcomes of Elderly Patients With Glioblastoma Multiforme in Their 75th Year or Older Treated With Adjuvant Therapy

Harris, Georgia; Jayamanne, Dasantha; Wheeler, Helen; Gzell, Cecelia; Kastelan, Marina; Schembri, Geoffrey; Brazier, David; Cook, Raymond; Parkinson, Jonathan; Khasraw, Mustafa; Louw, Sandra; Back, Michael

doi:10.1016/j.ijrobp.2017.02.028

Cited by 26 publications

(22 citation statements)

References 37 publications

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“…1 More recently, the intergroup randomized trial by Perry et al 18 comparing short-course radiotherapy with concurrent short-course chemoradiotherapy, in an older population with a median age of 73 years, has shown an improvement in median survival. Other retrospective studies 19 have shown potential benefit with chemotherapy when added to adjuvant radiotherapy in an even older patient population with a median age of 79 years. However, patient selection in this older age group becomes imperative.…”

Section: Discussionmentioning

confidence: 99%

Survival improvements with adjuvant therapy in patients with glioblastoma

Jayamanne

Wheeler

Cook

et al. 2017

ANZ Journal of Surgery

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This study confirms the significant improvement in median survival in GBM that has occurred in recent years since introduction of the EORTC-NCIC protocol. Further improvements have occurred presumably related to subspecialized care, improved resection rates, sophisticated radiotherapy targeting and early systemic salvage therapies. However, the burden of the disease within the community remains high and the median survival improvements over time have plateaued.

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Section: Discussionmentioning

confidence: 99%

Survival improvements with adjuvant therapy in patients with glioblastoma

Jayamanne

Wheeler

Cook

et al. 2017

ANZ Journal of Surgery

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“…In many clinical trials, higher age is an exclusion criterion, and historically, many elderly patients received no tumor-specific therapy but best supportive care [ 7 , 8 ]. Due to general condition (frailty) and comorbidities, treating elderly patients with HGG is challenging, and multidisciplinary approaches are required [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life and distress in elderly vs. younger patients with high-grade glioma—results of a multicenter study

Renovanz

Hickmann

Nadji-Ohl

et al. 2020

Support Care Cancer

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Objective Half of all newly diagnosed patients with glioblastoma are > 65 years still with a poor prognosis. Preserving quality of life is of high importance. However, patient reported outcome (PRO) data in this patient group is rare. The aim was to compare health-related quality of life (HRQoL) and distress between elderly and younger patients with high-grade glioma (HGG). Methods We used baseline data of a prospective study where HGG patients were enrolled from 4 hospitals. Distress was measured using the distress thermometer (DT), HRQoL using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) plus brain module (BN20). We compared distress and HRQoL by age (≥ 65 vs. < 65 years), gender, performance score, and time since diagnosis using multivariate linear and logistic regressions. Results A total of n = 93 (30%) out of n = 309 patients were ≥ 65 years (mean 70 years, range 65-86 years). Mean DT score of elderly patients (5.2, SD 2.6) was comparable with younger patients (4.9, SD 2.6). Elderly patients reported significantly lower global health (GHS, mean elderly vs. younger; 50.8 vs. 60.5, p = 0.003), worse physical (56.8 vs. 73.3, p < 0.001) and lower cognitive functioning (51.1 vs. 63.2, p = 0.002), worse fatigue (52.5 vs. 43.5, p = 0.042), and worse motor dysfunction (34.9 vs. 23.6, p = 0.030). KPS and not age was consistently associated with HRQoL. Conclusion Physical functioning was significantly reduced in the elderly compared with younger HGG patients, and at the same time, emotional functioning and DT scores were comparable. KPS shows a greater association with HRQoL than with calendric age in HGG patients reflecting the particular importance for adequate assessment of HRQoL and general condition in elderly patients.

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“…Univariate analysis showed that age was not significantly associated with overall survival in the CGGA cohort, while a significant association was observed in the TCGA cohort. Age at diagnosis is a major predictor of patient survival, and younger patients tend to survive longer than the older patients 8,14,15 . However, age alone is not a predictor for survival in GBM because older patients are less likely to receive adjuvant treatment 16 .…”

Section: Discussionmentioning

confidence: 99%

A RNA sequencing-based six-gene signature for survival prediction in patients with glioblastoma

Zuo

Zhang

Wang

2019

Sci Rep

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Glioblastoma (GBM) is an aggressive tumor of the central nervous system that has poor prognosis despite extensive therapy. Therefore, it is essential to identify a gene expression-based signature for predicting GBM prognosis. The RNA sequencing data of GBM patients from the Chinese Glioma Genome Atlas (CGGA) and The Cancer Genome Atlas (TCGA) databases were employed in our study. The univariate and multivariate regression models were utilized to assess the relative contribution of each gene to survival prediction in both cohorts, and the common genes in two cohorts were identified as a final prognostic model. A prognostic risk score was calculated based on the prognostic gene signature. This prognostic signature stratified the patients into the low- and high-risk groups. Multivariate regression and stratification analyses were implemented to determine whether the gene signature was an independent prognostic factor. We identified a 6-gene signature through univariate and multivariate regression models. This prognostic signature stratified the patients into the low- and high-risk groups, implying improved and poor outcomes respectively. Multivariate regression and stratification analyses demonstrated that the predictive value of the 6-gene signature was independent of other clinical factors. This study highlights the significant implications of having a gene signature as a prognostic predictor in GBM, and its potential application in personalized therapy.

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Survival Outcomes of Elderly Patients With Glioblastoma Multiforme in Their 75th Year or Older Treated With Adjuvant Therapy

Cited by 26 publications

References 37 publications

Survival improvements with adjuvant therapy in patients with glioblastoma

Survival improvements with adjuvant therapy in patients with glioblastoma

Health-related quality of life and distress in elderly vs. younger patients with high-grade glioma—results of a multicenter study

A RNA sequencing-based six-gene signature for survival prediction in patients with glioblastoma

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